The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
This document discusses medication non-compliance in chronic mental illnesses. It notes that non-compliance is the number one cause of increasing disability in these illnesses. It outlines reasons for non-compliance including disease factors like poor insight and treatment factors like side effects. Consequences of non-compliance include relapse and worsening of symptoms over time. The document recommends strategies like psychoeducation, family support, and long-acting injectable medications to improve medication adherence.
The document discusses factors that affect patient compliance with medical treatment. It examines compliance vs adherence and discusses factors like individual characteristics, disease factors, environmental factors, and the practitioner-patient relationship. Educational interventions have been found to have limited effectiveness on compliance, while behavioral strategies that focus on changing behaviors have been more effective. Reasons patients give for non-compliance include issues like side effects, cost, forgetting, and lack of belief in treatment effectiveness.
it is a very important topic in healthcare management. Pharmacist being the end point of contact for medicine use, he/she must be very careful in explaining the same to the patients while dispensing.
From Medical perspective, patients who don’t comply with doctors orders are usually seen as deviant and deviance needs correction
But many chronically view their behavior differently, as matter of self regulation
American Sociologist Peter Conrad
A good working atmosphere and healthy moral climate makes therapeutic efforts more easy in all Institutions
The document discusses various forms of non-compliance with medication regimens, including forgetting to take medications, taking less than the recommended dose, and failing to fill prescriptions. It notes that non-compliance is a major cause of wasted medication and occurs in about 50% of patients. Reasons for non-compliance include medication costs, fear of side effects, distrust of doctors, and reluctance to acknowledge illness. Having multiple prescriptions can also increase non-compliance rates.
The document discusses adherence counseling for antiretroviral (ART) treatment. It defines adherence and describes how at least 95% adherence is needed to suppress viral loads and avoid resistance. Barriers to adherence like socioeconomic factors, mental health issues, and stigma are discussed. Effective counseling techniques are described to help patients overcome barriers, integrate medications into daily routines, and promote family support to improve long-term adherence.
DEFINITION
BACKGROUND
METHODS OF ASSESSING COMPLIANCE.
Factors concerned with compliance.
BARRIERS TO COMPLIANCE
IMPROVEMENT OF COMPLIANCE .
NON-COMPLIANCE FACTORS.
This document discusses drug compliance and factors that influence a patient's adherence to medication regimens. It begins by defining compliance and its importance, noting that up to 50% of patients do not take medications as prescribed. Factors that can contribute to poor compliance include patient-related issues like a lack of understanding, physician-related problems like poor communication, and therapy challenges such as complex dosing schedules. The document then outlines several methods that can be used to measure and evaluate compliance, and provides strategies doctors can implement to improve patient adherence, such as simplifying treatment plans, educating patients, and involving family members.
This document discusses medication non-compliance in chronic mental illnesses. It notes that non-compliance is the number one cause of increasing disability in these illnesses. It outlines reasons for non-compliance including disease factors like poor insight and treatment factors like side effects. Consequences of non-compliance include relapse and worsening of symptoms over time. The document recommends strategies like psychoeducation, family support, and long-acting injectable medications to improve medication adherence.
The document discusses factors that affect patient compliance with medical treatment. It examines compliance vs adherence and discusses factors like individual characteristics, disease factors, environmental factors, and the practitioner-patient relationship. Educational interventions have been found to have limited effectiveness on compliance, while behavioral strategies that focus on changing behaviors have been more effective. Reasons patients give for non-compliance include issues like side effects, cost, forgetting, and lack of belief in treatment effectiveness.
it is a very important topic in healthcare management. Pharmacist being the end point of contact for medicine use, he/she must be very careful in explaining the same to the patients while dispensing.
From Medical perspective, patients who don’t comply with doctors orders are usually seen as deviant and deviance needs correction
But many chronically view their behavior differently, as matter of self regulation
American Sociologist Peter Conrad
A good working atmosphere and healthy moral climate makes therapeutic efforts more easy in all Institutions
The document discusses various forms of non-compliance with medication regimens, including forgetting to take medications, taking less than the recommended dose, and failing to fill prescriptions. It notes that non-compliance is a major cause of wasted medication and occurs in about 50% of patients. Reasons for non-compliance include medication costs, fear of side effects, distrust of doctors, and reluctance to acknowledge illness. Having multiple prescriptions can also increase non-compliance rates.
The document discusses adherence counseling for antiretroviral (ART) treatment. It defines adherence and describes how at least 95% adherence is needed to suppress viral loads and avoid resistance. Barriers to adherence like socioeconomic factors, mental health issues, and stigma are discussed. Effective counseling techniques are described to help patients overcome barriers, integrate medications into daily routines, and promote family support to improve long-term adherence.
DEFINITION
BACKGROUND
METHODS OF ASSESSING COMPLIANCE.
Factors concerned with compliance.
BARRIERS TO COMPLIANCE
IMPROVEMENT OF COMPLIANCE .
NON-COMPLIANCE FACTORS.
This document discusses drug compliance and factors that influence a patient's adherence to medication regimens. It begins by defining compliance and its importance, noting that up to 50% of patients do not take medications as prescribed. Factors that can contribute to poor compliance include patient-related issues like a lack of understanding, physician-related problems like poor communication, and therapy challenges such as complex dosing schedules. The document then outlines several methods that can be used to measure and evaluate compliance, and provides strategies doctors can implement to improve patient adherence, such as simplifying treatment plans, educating patients, and involving family members.
This document discusses medication adherence. It defines medication adherence as taking medications correctly as prescribed by doctors. Key benefits include improved safety, lower costs, and better health outcomes. Adherence is preferred over compliance, which suggests passive following of orders. Factors affecting adherence include socioeconomic issues, health systems, the condition, therapy aspects, and patient-related factors. Non-adherence can be intentional or unintentional. Consequences are increased hospitalizations, worsening disease, higher costs and reduced quality of life. Pharmacists can help with adherence by educating patients about their medications, recommending reminder tools, discussing costs and doing medication reviews.
This document discusses medication adherence and strategies to improve it. It defines medication adherence as a patient conforming to a provider's recommendations regarding timing, dosage, and frequency of medication. Non-adherence is estimated to cost $100-300 billion annually and cause 125,000 deaths. The five dimensions of non-adherence are socioeconomic factors, condition-related factors, therapy-related factors, patient-related factors, and health systems factors. Strategies to improve adherence include simplifying regimens, imparting knowledge, modifying beliefs and behaviors, providing communication and trust, addressing biases, and evaluating adherence.
Within integrative medicine “adherence” is more than ensuring patients remembering to take their medication. It's about adhering to a new lifestyle, exercise routine, ditching bad habits, incorporating a new nutrition plan (in addition to medication or supplement use). This slide show take a look at the differences between "patient adherence" and "patient compliance", areas of adherence, the consequences of non-adherence and what you can do as their healthcare professional.
Clinical pharmacy involves optimizing patient outcomes through the appropriate use of medications. It includes activities performed by pharmacists in various settings to develop and promote rational medication use. The overall goal is to maximize clinical effects, minimize risks, and reduce healthcare costs through counseling patients before, during, and after prescriptions. Key aspects of clinical pharmacy differ from traditional pharmacy in focusing on analyzing population needs related to medications and their effects on individual patients.
This document discusses patient adherence to medical treatment. It begins by noting estimates that 30-50% of medicines for long-term illnesses are not taken as directed, representing a loss for patients and the healthcare system. Common myths about non-adherence are debunked, and it is argued that patients' perceptions of their illness and prescribed treatment strongly influence adherence. Effective interventions should aim to improve the fit between patients' illness beliefs and treatment recommendations by addressing concerns about necessity and potential adverse effects through clear communication and education.
The document discusses medication non-adherence and strategies for improving adherence and ensuring safe hospital discharges. It notes that 50% of prescribed medications are not taken correctly and identifies barriers to adherence like cost, side effects, and health literacy. It introduces the Case Management Adherence Guidelines (CMAG) which assess patient knowledge, motivation, and skills to improve adherence using tools like health literacy tests. CMAG provides an algorithm to improve understanding and motivate patients to take medications as prescribed. The document emphasizes the importance of educating patients before discharge to maintain treatment and ensure a safe transition to outpatient care.
This document outlines a 4-phase treatment plan: Phase 1 involves diagnostic assessment, medication selection, and psychosocial challenges. Phase 2 focuses on stabilization through monitoring, psychoeducation, and group therapy. Phase 3 emphasizes symptom remission and control through medication titration and behavior management. Phase 4 provides psychoeducation on relapse prevention, works on interpersonal skills, and assesses social support systems.
This document discusses medication adherence and provides information on improving it. It defines medication adherence and discusses the burden of non-adherence, including economic costs and impacts on clinical outcomes. It describes factors that influence adherence, such as health system issues, patient factors, therapy complexity, and socioeconomic barriers. Effective interventions to improve adherence include simplifying regimens, educating patients, addressing beliefs, improving communication, evaluating adherence, and using team-based care approaches. Tools and resources are also provided.
This document discusses medication adherence, which refers to patients taking medications as prescribed by healthcare providers. Around 125,000 people die each year due to failure to take or improperly take medications. The document explores differences between adherence and compliance, statistics on adherence, factors influencing adherence, and the importance of adherence. It also provides a clinical case study of a patient with low adherence and the barriers and health impacts.
This document discusses strategies to enhance patient adherence to preventive dental programs. It defines key terms like adherence and compliance. It outlines factors that influence patient adherence like patient characteristics and relationships with providers. It also examines protocols to assess adherence using indices and discusses monitoring adherence over time. Finally, it presents strategies to promote adherence like patient education, counseling, stage-based models, and motivational interviewing. The goal is to properly identify strategies tailored for each individual patient's needs.
Patient medication adherence, Medication adherence, Causes of medication non-adherence, Problems linked with Medication Non-adherence, Factors affecting medication adherence, Patient related factors, Social and Economic factor, Disease related factor, Health care provider related factors, Therapy related factors, pharmacist role in the medication adherence, role of pharmacist in the medication adherence, monitoring of patient medication adherence, Direct method, Indirect method
This document discusses patient medication adherence. It defines adherence as taking medication as recommended by a healthcare provider. Adherence is affected by social, economic, healthcare system, condition-related, and patient-related factors. The five main dimensions that determine adherence are social/economic factors, provider-patient/healthcare system factors, condition-related factors, therapy-related factors, and patient-related factors. The role of pharmacists is to improve communication, provide education, simplify treatment regimens, monitor side effects, and involve patients to enhance medication adherence.
This document discusses techniques for encouraging behavior change in patients. It explains motivational interviewing and the stages of change model, which are patient-centered approaches that explore and resolve ambivalence about behavior change. The biomedical model of simply telling patients what to do is compared to the psychosocial model of empowering patients as partners in their own care. Specific motivational interviewing techniques discussed include assessing a patient's barriers, priorities, readiness to change, and use of tools like the readiness ruler to evaluate importance and confidence in behavior change. The overall goal is a collaborative approach that helps patients move through stages of change at their own pace.
This document discusses patient compliance, which refers to how well a patient follows medical advice such as taking medications correctly. It notes that adherence is a more accurate term than compliance, as it implies patients actively participate in their own care rather than just following doctor's orders. The document outlines factors that affect compliance like education level and side effects, and notes the importance of compliance for conditions like diabetes or HIV. It also discusses methods to detect non-adherence, the role of pharmacists in improving compliance through education and counseling, and concludes that developing strong patient relationships can increase understanding and compliance.
Patient medication adherence is defined as the extent to which a patient follows the recommended treatment plan agreed upon with their healthcare provider. Adherence is determined by factors related to the patient's social and economic situation, their relationship with healthcare providers, the nature of their condition and treatment, and individual patient factors. There are several methods for measuring adherence, including electronic monitors, patient self-reports, pill counts, and pharmacy records. Pharmacists can play an important role in improving adherence through counseling, simplifying dosing instructions, setting reminders, and addressing any barriers patients face in taking their medications as prescribed.
This document discusses patient medication adherence. It defines adherence as taking medication as recommended by a healthcare provider. Non-adherence can be unintentional due to complex regimens or intentional if a patient stops medication. The World Health Organization identified 5 dimensions that influence adherence: social/economic factors, healthcare system factors, condition-related factors, therapy-related factors, and patient-related factors. Methods for measuring adherence include medication monitors, patient self-reports, pill counts, pharmacy records, and the Morisky Medication Adherence Scale. Pharmacists can improve adherence through education, simplifying regimens, identifying barriers, and reminding patients.
Medication Adherence , setting up directions .. Ahmed Nouri
presenting the terminology of adherence, statistics of non-adherence and its impact, why do patients have difficulty with treatment, how to measure and how to improve the adherence, in addition to the role of the pharmacist in improving adherence.
Knowledge, Attitude and Practice of Self-Medication among Medical Studentsiosrjce
Self-medication is a common practice worldwide and the irrational use of the drugs is a major
cause of concern. Self-medication is an issue with serious global implication. The current study aimed to
determine the Knowledge, Attitude and Behavior of self-medication by medical students. A descriptive crosssectional
study was conducted among medical students currently studying first year to assess knowledge,
attitude and practice regarding self-medication in Chitwan Medical College, Bharatpur, Nepal. Seventy five
students studying in first year were selected for the study using stratified random sampling technique and data
was collected using a semi-structured self-administered questionnaire. The study finding revealed, the mean age
of 75 enrolled students was 20 years, 65.3% were in the age group of 17-20 years. Most of them were female
(72%). Seventy three point three percent belong to urban area. Prevalence rate of self-medication of one year
period seems high i.e. 84% and 68.25% in were females. The most common sources of information used by the
respondent were pharmacist (60.31%) and text book (46.03%). More than half of the respondent found to have
a good knowledge about self-medication regarding definition, adverse effect and different types of drug. The
attitude was positive towards self-medication and favored self-medication saying that it was acceptable. The
principal morbidities for seeking self-medication include cold and cough as reported by 85.7% followed by pain
76.2%, fever 73%, diarrhea 47.6% and dysmenorrheal 46%. Drugs / drugs group commonly used for selfmedication
included analgesics 75.8%, and anta-acids 53.2% and antipyretic 46.3%. Among reasons for
seeking self-medication, 79.2% felt that their illness was minor while 61.9% preferred as it is due to previous
experience. This study shows that self-medication is widely practiced among first year students of this medical
institution. There is dire need to make them aware about the pros and cons of self-medication in order to ensure
safe usage of drugs.
Patients often do not fully adhere to medical advice for several reasons: they may forget to follow regimens, feel side effects outweigh benefits, or be unable to afford treatments. Non-adherence is difficult to measure accurately and is common, with some studies finding only about 60% of patients still adhering to long-term regimens after a few years. Multiple factors influence adherence, including characteristics of the treatment regimen, the patient's cognitive and emotional state, psychosocial support, medical knowledge and beliefs. Improving communication between doctors and patients can help increase adherence.
Patient compliance refers to how well a patient follows medical advice, especially regarding medication. Compliance can be full, partial, or non-existent. Adherence is a more active choice by the patient to follow treatment while taking responsibility for their health. Factors affecting compliance include the patient's social and economic situation, their relationship with healthcare providers, characteristics of the disease and treatment, and individual factors like age and memory. Compliance can be measured directly through medical tests or indirectly through prescription refills, outcomes, and patient interviews. Pharmacists can help improve compliance through education, monitoring therapy, and simplifying dosing.
Substance abuse has significant negative impacts on mental health. It can lead to the development of mental health conditions like depression and anxiety. People who abuse substances often have co-occurring mental illnesses. Treating both substance abuse and mental health issues simultaneously is challenging and integrated treatment approaches are needed. Substance abuse disorders are also linked to poorer psychosocial functioning and problems with relationships, work, and daily life. Women may be particularly vulnerable as substance abuse can stem from attempts to self-medicate physical or mental health conditions.
This document discusses medication adherence. It defines medication adherence as taking medications correctly as prescribed by doctors. Key benefits include improved safety, lower costs, and better health outcomes. Adherence is preferred over compliance, which suggests passive following of orders. Factors affecting adherence include socioeconomic issues, health systems, the condition, therapy aspects, and patient-related factors. Non-adherence can be intentional or unintentional. Consequences are increased hospitalizations, worsening disease, higher costs and reduced quality of life. Pharmacists can help with adherence by educating patients about their medications, recommending reminder tools, discussing costs and doing medication reviews.
This document discusses medication adherence and strategies to improve it. It defines medication adherence as a patient conforming to a provider's recommendations regarding timing, dosage, and frequency of medication. Non-adherence is estimated to cost $100-300 billion annually and cause 125,000 deaths. The five dimensions of non-adherence are socioeconomic factors, condition-related factors, therapy-related factors, patient-related factors, and health systems factors. Strategies to improve adherence include simplifying regimens, imparting knowledge, modifying beliefs and behaviors, providing communication and trust, addressing biases, and evaluating adherence.
Within integrative medicine “adherence” is more than ensuring patients remembering to take their medication. It's about adhering to a new lifestyle, exercise routine, ditching bad habits, incorporating a new nutrition plan (in addition to medication or supplement use). This slide show take a look at the differences between "patient adherence" and "patient compliance", areas of adherence, the consequences of non-adherence and what you can do as their healthcare professional.
Clinical pharmacy involves optimizing patient outcomes through the appropriate use of medications. It includes activities performed by pharmacists in various settings to develop and promote rational medication use. The overall goal is to maximize clinical effects, minimize risks, and reduce healthcare costs through counseling patients before, during, and after prescriptions. Key aspects of clinical pharmacy differ from traditional pharmacy in focusing on analyzing population needs related to medications and their effects on individual patients.
This document discusses patient adherence to medical treatment. It begins by noting estimates that 30-50% of medicines for long-term illnesses are not taken as directed, representing a loss for patients and the healthcare system. Common myths about non-adherence are debunked, and it is argued that patients' perceptions of their illness and prescribed treatment strongly influence adherence. Effective interventions should aim to improve the fit between patients' illness beliefs and treatment recommendations by addressing concerns about necessity and potential adverse effects through clear communication and education.
The document discusses medication non-adherence and strategies for improving adherence and ensuring safe hospital discharges. It notes that 50% of prescribed medications are not taken correctly and identifies barriers to adherence like cost, side effects, and health literacy. It introduces the Case Management Adherence Guidelines (CMAG) which assess patient knowledge, motivation, and skills to improve adherence using tools like health literacy tests. CMAG provides an algorithm to improve understanding and motivate patients to take medications as prescribed. The document emphasizes the importance of educating patients before discharge to maintain treatment and ensure a safe transition to outpatient care.
This document outlines a 4-phase treatment plan: Phase 1 involves diagnostic assessment, medication selection, and psychosocial challenges. Phase 2 focuses on stabilization through monitoring, psychoeducation, and group therapy. Phase 3 emphasizes symptom remission and control through medication titration and behavior management. Phase 4 provides psychoeducation on relapse prevention, works on interpersonal skills, and assesses social support systems.
This document discusses medication adherence and provides information on improving it. It defines medication adherence and discusses the burden of non-adherence, including economic costs and impacts on clinical outcomes. It describes factors that influence adherence, such as health system issues, patient factors, therapy complexity, and socioeconomic barriers. Effective interventions to improve adherence include simplifying regimens, educating patients, addressing beliefs, improving communication, evaluating adherence, and using team-based care approaches. Tools and resources are also provided.
This document discusses medication adherence, which refers to patients taking medications as prescribed by healthcare providers. Around 125,000 people die each year due to failure to take or improperly take medications. The document explores differences between adherence and compliance, statistics on adherence, factors influencing adherence, and the importance of adherence. It also provides a clinical case study of a patient with low adherence and the barriers and health impacts.
This document discusses strategies to enhance patient adherence to preventive dental programs. It defines key terms like adherence and compliance. It outlines factors that influence patient adherence like patient characteristics and relationships with providers. It also examines protocols to assess adherence using indices and discusses monitoring adherence over time. Finally, it presents strategies to promote adherence like patient education, counseling, stage-based models, and motivational interviewing. The goal is to properly identify strategies tailored for each individual patient's needs.
Patient medication adherence, Medication adherence, Causes of medication non-adherence, Problems linked with Medication Non-adherence, Factors affecting medication adherence, Patient related factors, Social and Economic factor, Disease related factor, Health care provider related factors, Therapy related factors, pharmacist role in the medication adherence, role of pharmacist in the medication adherence, monitoring of patient medication adherence, Direct method, Indirect method
This document discusses patient medication adherence. It defines adherence as taking medication as recommended by a healthcare provider. Adherence is affected by social, economic, healthcare system, condition-related, and patient-related factors. The five main dimensions that determine adherence are social/economic factors, provider-patient/healthcare system factors, condition-related factors, therapy-related factors, and patient-related factors. The role of pharmacists is to improve communication, provide education, simplify treatment regimens, monitor side effects, and involve patients to enhance medication adherence.
This document discusses techniques for encouraging behavior change in patients. It explains motivational interviewing and the stages of change model, which are patient-centered approaches that explore and resolve ambivalence about behavior change. The biomedical model of simply telling patients what to do is compared to the psychosocial model of empowering patients as partners in their own care. Specific motivational interviewing techniques discussed include assessing a patient's barriers, priorities, readiness to change, and use of tools like the readiness ruler to evaluate importance and confidence in behavior change. The overall goal is a collaborative approach that helps patients move through stages of change at their own pace.
This document discusses patient compliance, which refers to how well a patient follows medical advice such as taking medications correctly. It notes that adherence is a more accurate term than compliance, as it implies patients actively participate in their own care rather than just following doctor's orders. The document outlines factors that affect compliance like education level and side effects, and notes the importance of compliance for conditions like diabetes or HIV. It also discusses methods to detect non-adherence, the role of pharmacists in improving compliance through education and counseling, and concludes that developing strong patient relationships can increase understanding and compliance.
Patient medication adherence is defined as the extent to which a patient follows the recommended treatment plan agreed upon with their healthcare provider. Adherence is determined by factors related to the patient's social and economic situation, their relationship with healthcare providers, the nature of their condition and treatment, and individual patient factors. There are several methods for measuring adherence, including electronic monitors, patient self-reports, pill counts, and pharmacy records. Pharmacists can play an important role in improving adherence through counseling, simplifying dosing instructions, setting reminders, and addressing any barriers patients face in taking their medications as prescribed.
This document discusses patient medication adherence. It defines adherence as taking medication as recommended by a healthcare provider. Non-adherence can be unintentional due to complex regimens or intentional if a patient stops medication. The World Health Organization identified 5 dimensions that influence adherence: social/economic factors, healthcare system factors, condition-related factors, therapy-related factors, and patient-related factors. Methods for measuring adherence include medication monitors, patient self-reports, pill counts, pharmacy records, and the Morisky Medication Adherence Scale. Pharmacists can improve adherence through education, simplifying regimens, identifying barriers, and reminding patients.
Medication Adherence , setting up directions .. Ahmed Nouri
presenting the terminology of adherence, statistics of non-adherence and its impact, why do patients have difficulty with treatment, how to measure and how to improve the adherence, in addition to the role of the pharmacist in improving adherence.
Knowledge, Attitude and Practice of Self-Medication among Medical Studentsiosrjce
Self-medication is a common practice worldwide and the irrational use of the drugs is a major
cause of concern. Self-medication is an issue with serious global implication. The current study aimed to
determine the Knowledge, Attitude and Behavior of self-medication by medical students. A descriptive crosssectional
study was conducted among medical students currently studying first year to assess knowledge,
attitude and practice regarding self-medication in Chitwan Medical College, Bharatpur, Nepal. Seventy five
students studying in first year were selected for the study using stratified random sampling technique and data
was collected using a semi-structured self-administered questionnaire. The study finding revealed, the mean age
of 75 enrolled students was 20 years, 65.3% were in the age group of 17-20 years. Most of them were female
(72%). Seventy three point three percent belong to urban area. Prevalence rate of self-medication of one year
period seems high i.e. 84% and 68.25% in were females. The most common sources of information used by the
respondent were pharmacist (60.31%) and text book (46.03%). More than half of the respondent found to have
a good knowledge about self-medication regarding definition, adverse effect and different types of drug. The
attitude was positive towards self-medication and favored self-medication saying that it was acceptable. The
principal morbidities for seeking self-medication include cold and cough as reported by 85.7% followed by pain
76.2%, fever 73%, diarrhea 47.6% and dysmenorrheal 46%. Drugs / drugs group commonly used for selfmedication
included analgesics 75.8%, and anta-acids 53.2% and antipyretic 46.3%. Among reasons for
seeking self-medication, 79.2% felt that their illness was minor while 61.9% preferred as it is due to previous
experience. This study shows that self-medication is widely practiced among first year students of this medical
institution. There is dire need to make them aware about the pros and cons of self-medication in order to ensure
safe usage of drugs.
Patients often do not fully adhere to medical advice for several reasons: they may forget to follow regimens, feel side effects outweigh benefits, or be unable to afford treatments. Non-adherence is difficult to measure accurately and is common, with some studies finding only about 60% of patients still adhering to long-term regimens after a few years. Multiple factors influence adherence, including characteristics of the treatment regimen, the patient's cognitive and emotional state, psychosocial support, medical knowledge and beliefs. Improving communication between doctors and patients can help increase adherence.
Patient compliance refers to how well a patient follows medical advice, especially regarding medication. Compliance can be full, partial, or non-existent. Adherence is a more active choice by the patient to follow treatment while taking responsibility for their health. Factors affecting compliance include the patient's social and economic situation, their relationship with healthcare providers, characteristics of the disease and treatment, and individual factors like age and memory. Compliance can be measured directly through medical tests or indirectly through prescription refills, outcomes, and patient interviews. Pharmacists can help improve compliance through education, monitoring therapy, and simplifying dosing.
Substance abuse has significant negative impacts on mental health. It can lead to the development of mental health conditions like depression and anxiety. People who abuse substances often have co-occurring mental illnesses. Treating both substance abuse and mental health issues simultaneously is challenging and integrated treatment approaches are needed. Substance abuse disorders are also linked to poorer psychosocial functioning and problems with relationships, work, and daily life. Women may be particularly vulnerable as substance abuse can stem from attempts to self-medicate physical or mental health conditions.
This study examined whether a psychological opioid-risk evaluation influenced physicians' opioid prescribing decisions for 151 chronic pain patients being considered for chronic opioid therapy. Patients underwent an evaluation that assigned them an opioid-risk level of low, moderate, or high. The evaluation report was made available to physicians before their follow-up appointment where prescribing decisions were made. Results found that risk level significantly predicted opioid prescribing, with lower risk patients more likely to be prescribed opioids. A history of substance abuse also predicted less likely opioid prescribing. Demographic factors did not significantly influence prescribing contrary to some previous research. This suggests providing additional information about patients' abuse risk aids prescribing decisions and may reduce bias.
The study assessed adherence to cardiovascular medications in rural patients attending a tertiary hospital in India. It found that adherence was lowest in hypertension patients at 20.83% and highest in ischemic heart disease patients at 32%. The most common reason for non-adherence was carelessness. The study concluded that rural Indians adhere poorly to cardiovascular medications and that more efforts are needed to address this issue.
An observational study of medicationadministration errors in.docxdaniahendric
An observational study of medication
administration errors in old-age
psychiatric inpatients
CAMILLA HAW, JEAN STUBBS AND GEOFF DICKENS
St. Andrew’s Hospital, Billing Road, Northampton, NN1 5DG, United Kingdom.
Abstract
Background. Relatively little is known about medication administration errors in mental health settings.
Objective. To investigate the frequency and nature of medication administration errors in old-age psychiatry. To assess the
acceptability of the observational technique to nurse participants.
Method. Cross-sectional study technique using (i) direct observation, (ii) medication chart review and (iii) incident reports.
Setting. Two elderly long-stay wards in an independent UK psychiatric hospital.
Participants. Nine nurses administering medication at routine medication rounds.
Main outcome measures. Frequency, type and severity of directly observed medication administration errors compared with
errors detected by retrospective chart review and incident reports.
Results. Using direct observation 369 errors in 1423 opportunities for errors (25.9%) were detected vs. chart review detected
148 errors and incident reports none. Most errors were of doubtful or minor severity. The pharmacist intervened on four
occasions to prevent an error causing patient harm. The commonest errors observed were unauthorized tablet crushing or
capsule opening (111/369, 30.1%), omission without a valid reason (100/369, 27.1%) and failure to record administration
(87/369, 23.6%). Among the nurses observed, the error rate varied widely from no errors to one error in every two doses
administered. Of the seven nurses who completed the post-observation questionnaire, all said they would be willing to be
observed again.
Conclusion. Medication administration errors are common and mostly minor. Direct observation is a useful, sensitive
method for detecting medication administration errors in psychiatry and detects many more errors than chart review or inci-
dent reports. The technique appeared to be acceptable to most of the nursing staff that were observed.
Keywords: administration, adverse drug events, elderly, medication errors, mental health, observation, psychiatry
Medication errors (prescribing, transcribing, dispensing and
administration errors) are an important cause of patient mor-
bidity and mortality [1]. Medication administration errors are
a common sub-type of medication errors and accounted for
34% of errors in one large USA study conducted in medical
and surgical units [2]. Observational studies in general hospi-
tals have yielded error rates varying between 3.5 and 27% of
doses [3–8]. Direct observation detects medication adminis-
tration errors at a much higher rate than chart review or inci-
dent report review [9]. The observational method has been
demonstrated to be valid and reliable [10].
Less research on medication errors has been conducted
in mental health settings, and little is known about the
incidence of medication admi ...
An observational study of medicationadministration errors in.docxamrit47
An observational study of medication
administration errors in old-age
psychiatric inpatients
CAMILLA HAW, JEAN STUBBS AND GEOFF DICKENS
St. Andrew’s Hospital, Billing Road, Northampton, NN1 5DG, United Kingdom.
Abstract
Background. Relatively little is known about medication administration errors in mental health settings.
Objective. To investigate the frequency and nature of medication administration errors in old-age psychiatry. To assess the
acceptability of the observational technique to nurse participants.
Method. Cross-sectional study technique using (i) direct observation, (ii) medication chart review and (iii) incident reports.
Setting. Two elderly long-stay wards in an independent UK psychiatric hospital.
Participants. Nine nurses administering medication at routine medication rounds.
Main outcome measures. Frequency, type and severity of directly observed medication administration errors compared with
errors detected by retrospective chart review and incident reports.
Results. Using direct observation 369 errors in 1423 opportunities for errors (25.9%) were detected vs. chart review detected
148 errors and incident reports none. Most errors were of doubtful or minor severity. The pharmacist intervened on four
occasions to prevent an error causing patient harm. The commonest errors observed were unauthorized tablet crushing or
capsule opening (111/369, 30.1%), omission without a valid reason (100/369, 27.1%) and failure to record administration
(87/369, 23.6%). Among the nurses observed, the error rate varied widely from no errors to one error in every two doses
administered. Of the seven nurses who completed the post-observation questionnaire, all said they would be willing to be
observed again.
Conclusion. Medication administration errors are common and mostly minor. Direct observation is a useful, sensitive
method for detecting medication administration errors in psychiatry and detects many more errors than chart review or inci-
dent reports. The technique appeared to be acceptable to most of the nursing staff that were observed.
Keywords: administration, adverse drug events, elderly, medication errors, mental health, observation, psychiatry
Medication errors (prescribing, transcribing, dispensing and
administration errors) are an important cause of patient mor-
bidity and mortality [1]. Medication administration errors are
a common sub-type of medication errors and accounted for
34% of errors in one large USA study conducted in medical
and surgical units [2]. Observational studies in general hospi-
tals have yielded error rates varying between 3.5 and 27% of
doses [3–8]. Direct observation detects medication adminis-
tration errors at a much higher rate than chart review or inci-
dent report review [9]. The observational method has been
demonstrated to be valid and reliable [10].
Less research on medication errors has been conducted
in mental health settings, and little is known about the
incidence of medication admi.
An observational study of medicationadministration errors in.docxgreg1eden90113
An observational study was conducted to investigate medication administration errors in two long-stay psychiatric wards for elderly patients in the UK. Direct observation of nurses administering medication detected 369 errors in 1423 doses administered, representing an error rate of 25.9%. The most common errors were unauthorized crushing of tablets, omission of doses without reason, and failure to record administration. Most errors were considered minor in severity. Direct observation detected substantially more errors than retrospective chart review or incident reports. Nurses found the observational technique acceptable.
1) The study evaluated medication adherence in 100 patients with chronic kidney disease (CKD) using the Morisky Medication Adherence Scale. 36% of patients showed low adherence.
2) Common causes of low adherence were complex dosing schedules (20%), difficulty taking a large number of pills daily (20%), and forgetfulness (18%). 70% of patients were unaware of the importance of each medication.
3) There were statistically significant positive correlations between poor adherence and the number of concurrent illnesses and number of medications taken daily. Improving patient awareness and simplifying dosing regimens can help enhance medication adherence in CKD patients.
Medication Adherence in America reportcard full by National Community Pharmac...Fran Maciel
This document provides a summary of key findings from the National Report Card on Medication Adherence survey conducted by the National Community Pharmacists Association. Some key findings include:
- The average adherence score among those surveyed was 79 out of 100, equivalent to a C+ grade. Scores varied based on factors like affordability of medications, connection to healthcare providers, and side effects.
- The top reasons for non-adherence were simply forgetting to take medications (41% of respondents) and running out of medication (top reasons also included being away from home, cost, and side effects).
- Regression modeling identified the strongest independent predictors of adherence as personal connection to a pharmacist, ability to afford medications, continuity in
The document summarizes research on the benefits of clinical pharmacists participating as members of medical teams. Several studies found that including clinical pharmacists reduced mortality rates in hospitals and improved outcomes across disease states. Pharmacists improved medication management by addressing drug-related problems, which led to decreased mortality for conditions like heart attacks. Their interventions enhanced clinical outcomes for diabetes, cardiovascular disorders, and other conditions. Effective implementation of these pharmacy services requires support from healthcare organizations and infrastructure support within facilities.
Patient compliance challenges in management of cardiac diseases in kuala lump...pharmaindexing
This study investigated the level of compliance among 400 cardiac patients in Kuala Lumpur and Perak, Malaysia. It found a 15.8% high adherence rate, 54.3% moderate adherence rate, and 30% poor adherence rate to cardiovascular medications. Major reasons for non-compliance were identified as attitudes and beliefs, lifestyle, side effects, and cost of medications. The study recommends that healthcare professionals, especially pharmacists and dispensing technicians, should provide better counseling to patients about their medications and conditions to improve compliance.
Patient compliance: Challenges in management of cardiac diseases in Kuala Lum...pharmaindexing
Background
The objective of this study was to investigate the degree of compliance among cardiac patients who attend the health facilities in Kuala Lumpur and Perak, Malaysia. The reasons for non-compliance and recommendations from healthcare professionals were also evaluated.
Method
A cross-sectional study of 400 patients and 100 healthcare professionals was carried out. This study utilizes variables on external factors and internal factors as the measurement tools. The questionnaire which consists of Morisky self-reported medication adherence questions was administered to patients and causes for non-compliance sought. Questionnaire for healthcare professionals was used to determine strategies that can improve compliance rate.
Results
The study revealed a 15.8% of high adherence rate, 54.3% of moderate adherence rate and 30% of poor adherence to cardiovascular disease medications. The chi-square tests showed the strong association between dependent and independent variables. The model chosen for testing the patient compliance through external and internal factors gives an R2 value of 85.0% with an adjusted R2 of 84.7%. The F value (317.187) was also significant (p=0.000) which means that the variables have better fit in the multivariate model. The major reasons determined for non-adherence were attitudes and beliefs, lifestyle, side effects and cost of medications. The study recommends that pharmacists and dispensing technicians should be adequately qualified to provide proper counselling to cardiac patients on their medicines and disease conditions.
Conclusion
The result of this study is of value to health care providers. Compliance to cardiovascular medications will avoid treatment failures encountered in therapy.
This document summarizes a study on barriers that rural physicians face in prescribing buprenorphine to treat opioid use disorder. The study surveyed rural physicians in the US with a Drug Enforcement Agency waiver to prescribe buprenorphine. It found that physicians not currently prescribing buprenorphine reported significantly more barriers than those who were, including time constraints, lack of specialty backup, and lack of confidence in managing opioid use disorder. The most commonly cited barriers across all physicians were concerns about diversion or misuse, time constraints, and lack of available mental health support services.
Evaluations of and Interventions for Non Adherence to Oral Medications as a P...NiyotiKhilare
The focus of this presentation will be medical non-adherence as a psychosocial issue in diabetes. The presentation will also focus elaborately on empowerment as an intervention amongst other interventions.
Assessment and evaluation of poly pharmacy associating factors including anti...MUSHTAQ AHMED
This study aimed to estimate the prevalence of polypharmacy, antibiotic and nutritional supplement use in hospital and community patients. A retrospective cross-sectional study analyzed 100 prescriptions from Lahore and Faisalabad, finding a 40% polypharmacy prevalence. 19% of patients took nutritional supplements. The most common drug interactions involved NSAIDs, antihypertensives and antibiotics. Polypharmacy was associated with diseases like diabetes and hypertension.
Assessment and evaluation of poly pharmacy associating factors including anti...MUSHTAQ AHMED
This study aimed to estimate the prevalence of polypharmacy, antibiotic and supplement use in patients through a retrospective analysis of prescriptions from hospitals and community pharmacies in Lahore and Faisal Abad, Pakistan. The prevalence of polypharmacy (use of 5+ medications) was 40%. Drug-drug interactions occurred in 17% of prescriptions. Factors associated with polypharmacy included diseases like diabetes, hypertension, and joint pains. The cost per prescription per day was 174.70 Pakistani rupees. Elderly patients commonly experienced polypharmacy and used supplements. Further analysis of prescribing patterns could help improve rational and cost-effective medical care.
Abstract—Prevalence of degenerative dementias and dementias associated with cerebrovascular disease is increasing with the time. Dementia is one of the most significant public health problems. Demographic data, medical history, general biochemical data and serum total homocysteine (tHcy) levels was used in this study to examine the differences between dementia and normal control groups. A cross-sectional study was conducted on 236 individuals who were above the age of 65 years. These participants went through the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), demographic characteristics, biochemical data and tHcy level. Each of the above mentioned factors was assessed. There were significant differences in the history of hypertension, diabetes mellitus, marital status, alcohol consumption (AC), BMI value, and triglyceride (TG) and serum tHcy levels. The logistic regression analysis showed significant differences in marital status, AC and tHcy. So it can be concluded that elevated serum tHcy, no AC and no partner are associated with the risk of dementia in elders of Southern Taiwan. It needs further researches to identify and reduce the risk of dementia.
Pharmaceutical Comparative Effectiveness Research AbstractLona Vincent
This document summarizes several research studies and articles in the field of health economics and outcomes research. It discusses trends in the use of electronic medical records in outcomes research from 2001-2010, with the number of studies increasing over time. It also reviews characteristics of homeless patients using inpatient and emergency services compared to non-homeless patients. Additionally, it compares the role of health technology assessment systems in reimbursement and market access between Turkey and Poland.
This study examined factors affecting adherence to Suboxone treatment among 50 African American patients through a retrospective chart review. The results showed significantly negative correlations between adherence and concurrent use of opioids, cocaine, and alcohol. Surprisingly, PTSD showed a positive correlation with adherence, contradicting other studies. No correlation was found between adherence and unemployment. The study concluded that while mental health issues and unemployment may impact adherence, the small sample size likely influenced the results. Larger studies are still needed to fully understand factors affecting Suboxone adherence in minority groups.
Similar to Factors Affecting Non-Compliance among Psychiatric Patients in the Regional Institute of Medical Sciences, Imphal. (20)
Congenital Agenesis Of The Corpus Callosum With Intracerebral Lipoma And Fron...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
“Hemodynamic and recovery profile with Dexmedetomidine and Fentanyl in intrac...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Correlation of Estrogen and Progesterone Receptor expression in Breast Canceriosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Analytical Study of Urine Samples for Epidemiology of Urinary Tract Infection...iosrphr_editor
The current study was carried out in District Abbottabad aimed to determine the common urinary
tract infections in local community to determine the epidemiology of significant diseases in asymptomatic patients
of renal disorder. In this study a total of 1000 urine samples were examined during 3rd February to 1st April 2015
from patients attending Ayub Teaching Hospital Abbottabad by using dipstick and microscopic analysis of urine.
There were 638 females and 362 males patients examined during this period. The range of age groups is between
1.5 years to 80 years. Results of this study was reported as Pyuria 11%, Proteinuria 21.1%, Hematuria 10.4%,
Epithelial Cells 8.2%, pH 7.8 %, Granular casts 7.3%, Triple phosphate 6.6%, Calcium oxalate 6.4%, Glycosuria
6.3%, Bacteria 6.2% and mucous 4.1%. This study concludes that routing urinalysis should be performed for all
individuals to diagnose the asymptomatic diseases that will help in simple therapeutic measurements as urinalysis
is a simple step to determine the root of Urinary tract disorders.
Chest sonography images in neonatal r.d.s. And proposed gradingiosrphr_editor
BACKGROUND : Lung sonography has been used to monitor the patients of R.D.S. in
N.I.C.U. in recent times.
AIMS : To Describe and Grade the changes of R.D.S. by lung sonography.
SETTING & DESIGN : Tertiary care institutional set up in a rural medical college.
STUDY DURATION : September 2014 to May 2015. Follow-up variable, upto 2 weeks.
PROSPECTIVE, ANALYTICAL STUDY.
MATERIALS AND METHODS -This was a single institute study approved by the institutional ethics
committee. Prior informed consent was obtained from the parents. 100 consecutive patients admitted in
N.I.C.U. WITH gestational age < 36 weeks with respiratory complaints were enrolled. Chest x-ray was
obtained within few hours of admission and lung sonography was performed within 24 hours. Follow – up
sonography was performed as and when necessary. Sonography image was graded and correlated with chest
xray and clinical picture
The Comprehensive Review on Fat Soluble Vitaminsiosrphr_editor
This review article deals with brief description of fat soluble vitamins with figures and tables
showing statistical analytical data duly quoting the references wherever necessary. The word “soluble” actually
means “able to be dissolved.” Whether a vitamin is classified as 'fat-soluble' or 'water-soluble' has to do with
how the vitamin is absorbed, stored and removed from the body. Vitamins are tiny organic compounds with a
huge impact on the health and well-being of the body. The body needs a small amount of fat soluble vitamins in
order to stay in optimal health. Fat soluble vitamins play an important role in keeping the body healthy and
functioning from immune system and muscle and heart function, easy flow and clotting of blood as well as eye
health. They are critical to health and wellness–particularly reproductive health and wellness. Low-fat, no-fat
and vegan diets are woefully lacking in fat soluble vitamins. However a diet based on traditional foods can
naturally provide these vitamins. Science is still learning about many of the functions of vitamins. "Too much
vitamin A, D, or K can lead to increased levels that are unhealthy and can cause serious health consequences.
Diseased conditions leading to decreased fat absorption leads to decreased absorption of vitamins. The fatsoluble
vitamins work most safely and effectively when obtained them from natural foods within the context of a
diet rich in all their synergistic partners. If fat soluble vitamins are stored for lengthy time they generate threat
for toxicity than water soluble vitamins and such situation even aggravated, provided they are consumed in
excess. Vitamin products, above the legal limits are not considered food supplements and must be registered as
prescription or non-prescription (over-the-counter drugs) due to their potential side effects. Vitamin A and E
supplements do not provide health benefits for healthy individuals, instead they may enhance mortality, and it is
held proved that beta-carotene supplements can be harmful to smokers
Sulphasalazine Induced Toxic Epidermal Necrolysis A Case Reportiosrphr_editor
The document describes a case study of an 18-year-old female patient who developed toxic epidermal necrolysis as a severe adverse reaction to the drug sulfasalazine, which she had been taking for ankylosing spondylitis. She was admitted to the intensive care unit and treated with high dose corticosteroids, fluid replacement, and supportive care. She improved with treatment and was discharged with only post-inflammatory hypopigmentation.
Evaluation the efficacy of IVIgG in treatment of Hemolytic Disease of Newborniosrphr_editor
Hemolytic disease of newborn (HDN) is an important cause of hyperbilirubinemia in the
neonatal period,and delayed diagnosis and treatment may lead to permanent brain damage. Traditional
neonatal treatment of HDN is intensive phototherapy and exchange transfusion.Intravenous
immunoglobulin(IVIgG) has been introduced as an alternative therapy to exchange transfusion. This study was
conducted to assess the effect of IVIG in HDN .
FIBROLIPOMATOUS HAMARTOMA OF ULNAR NERVE: A RARE CASE REPORT.iosrphr_editor
Nervous fibrolipomatous hamartoma is said to be a rare tumor-like condition involving the peripheral
nerves,in which the epineurium and perineurium are enlarged and distorted by excess of fatty and fibrous tissue
s that infiltrate between and around nerve boundaries. The median nerve is more likely to develop a hamartoma
than other nerves with a predilection for the carpal tunnel.
A fibrolipomatous hamartoma – is a rare, benign, congenital lesion most commonly found in the median nerve,
usually at the level of the wrist or hand.
We report a case of this rare condition in ulnar nerve.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
This study examined self-medication practices for oral health problems among dental patients in Bangalore, India. The study found that 100% of the 175 dental patients surveyed practiced self-medication. Toothache was the most common triggering factor reported. Analgesics and herbal remedies were commonly used for self-treatment. Most participants consulted pharmacists for advice on self-medication and would see a dentist only if problems persisted after self-medicating. The high prevalence of self-medication indicates a need for education programs to increase awareness of risks.
Clinico-haematological Profile of Falciparum Malaria in a Rural Hospital of T...iosrphr_editor
Aim: To study the clinico-haematological profile malaria in a rural hospital of Tripura.
Material and methods: A cross-sectional hospital-based study was done from at Kulai District
Hospital,Tripura. This hospital based cross sectional study was done on 60 confirmed cases of falciparum
malaria (either by peripheral smear or rapid diagnostic test) admitted in Kulai District Hospital. A case sheet
proforma was prepared and data (demographic profile,clinical feature, investigation, treatment, and
complication) from all indoor patients was collected and analyzed.
Result: Out of 60 patients, 40(66.6%) were males and 20 (33.4%) were females. Most of the patients were
between the age group 21-40 years with the highest prevalence between the age group of 21-30. Fever was the
most common symptom. Anemia was present in 42(70%) patients, out of which 6(10%) patients had severe
anemia. Thrombocytopenia was present in 36(60%) patients.Abnormal liver function tests were observed in
26(43.3%) subjects while abnormal kidney function tests were observed in16(26.6%) patients. All the 60
patients received Artemisinin based antimalarial drugs.
Conclusion: Early detection, prompt management, and adequate supportive therapy may reduce mortality due
to falciparum cerebral malaria.
Indonesian Wild Ginger (Zingiber sp) Extract: Antibacterial Activity against ...iosrphr_editor
The document summarizes a study that tested the antibacterial activity of extracts from three species of wild ginger plants from Indonesia (Zingiber zerumbet, Zingiber amaricans, and Zingiber aromaticum) against Mycoplasma gallisepticum, a pathogen that causes respiratory disease in chickens. Phytochemical analysis revealed the presence of alkaloids, flavonoids, tannins, and terpenoids in the plant extracts. Disc diffusion and minimum inhibitory concentration assays showed that ethanol extracts of dried rhizomes had the strongest inhibitory effects against the pathogen, with minimum inhibitory concentrations ranging from 7.8 to 31.2 mg/ml. The results suggest that extracts from these wild ginger plants
A case of allergy and food sensitivity: the nasunin, natural color of eggplantiosrphr_editor
Abstract: Allergies and food sensitivities can both be considered as "adverse reactions individualistic" to food.
Are pathological and individual forms because they affect a few individuals in way rather serious; immediate
or delayed reactions occur instead with simple effects histamine, or, in severe cases with respiratory and
anaphylactic shock
The eggplant (Solanum melongena L.) is known to cause food allergies in some Asian countries, but detailed
studies on allergies caused by eggplant are lacking, however, it was highlighted the presence of allergens in
edible parts of eggplant with preponderance in the peel .
The purpose of this study was to propose an extraction method rapid, efficient and cost of natural dye from
waste products from the food industry, such as the peels of eggplant, from which it was extracted, isolated and
purified the nasunin,a colored molecule in red-fuchsia.
Nasusin was tested on 58 patients to evaluate the potential sensitizing effect on the skin. The results demonstrate
that allergenic effects are negligible and therefore the nasunin can be used as a colorant in various industrial
sectors with a certain safety margin
Complete NMR Assignment of MogrosidesII A2, II E andIII A1Isolated from Luo H...iosrphr_editor
NMR analysis allowed complete assignments of three known mogrol glycosides, Mogroside IIA2 (1),
II E (2)and IIIA1 (3), isolated from the extracts of Luo Han Guo. Herein, complete 1H and 13C NMR
assignmentsof all threemogrosidesare described based on NMR experiments (1H NMR, 13C NMR, COSY,
HSQC-DEPT, HMBC, NOESY and 1DTOCSY) and mass spectral data.
Nanoemulsion and Nanoemulgel as a Topical Formulationiosrphr_editor
: Nanoemulsion is referred type of emulsion with uniform and extremely small droplet size in the range
of 20-200 nm. Nanoemulsion provides numerous advantages over other carrier such as polymeric nanoparticle
and liposomes, including low cost preparation procedure, high hydrophilic and lipophilic drug loading system
to enhance the longer shelf live upon preserving the therapeutic agents. Incorporating the preparation of
nanoemulsion with hydrogel matrix to produce nanoemulgel exhibited by the two separate systems that forming
it. Nanoemulgel possesses the properties of thixotropic, non-greasy, effortlessly spreadable, easily be removed,
emollient, not staining, soluble in water, longer shelf life, bio-friendly, translucent and agreeable appearance.
Pharmacokinetics of High-Dose Methotrexate in Egyptian Children with Acute Ly...iosrphr_editor
Aim:Since several factors have been shown to influence the clearance of methotrexate, the purpose of this study
was to identify potential relationships between patient covariates and the methotrexate clearance estimates and
deduce a pharmacokinetic model for the estimation of methotrexate clearance in Egyptian pediatric ALL
patients that may help dosage adjustment and achieve target steady-state plasma concentrations in a similar
sittings.
Patients and methods: A total of 94 pediatric patients with B-cell ALL, of whom 70 were the studied population
and 24 were the test population, were treated with four courses of HDMTX doses 2.5 gm/m2
(low-risk arm) or 5
gm/m2
(standard-/high-risk arm) given every other week by intermittent intravenous infusions over 24 hours as
a part of their treatment protocol. Patients were monitored for the 24 hour MTX concentration and the systemic
methotrexate clearance was calculated for each methotrexate dose
Epidemiology of Tuberculosis (TB) in Albania 1998-2009iosrphr_editor
Abstract : In Albania, many people erroneously think that tuberculosis (TB) is a disease of the past-an illness
that no longer constitutes a public health threat. Surveillance is an integral part of tuberculosis (TB) control.
Albania has a highTB notification rate and there are doubts about underreporting. The evolution of the
incidence of tuberculosis is presented, together with more detailed figures over the period 1998-2009. These
figures were obtained by the monthly forms (called 14/Sh) compared with the individual notification data.
Objective: To examine the distribution and sources of increased tuberculosis (TB) morbidity and reporting
system deficiencies in the Albania from 1998 through 2009. Metodology: The study is descriptive one conductet
during the period 1998-2009. The statistical analysis is based on data reported from regional level (regional
epidemiological departments) to the central level (Public Health Institute). Results: The main findings were:
discordance between the collected data (individual form) and reported data (monthly form); tuberculosis
incidence rate shows little oscillations which ranges from 6.67 to 9.2 cases/100.000 population; 50% of the
regions show a lack of information on the confirmation of diagnosis and laboratory examination type used for
confirmation. Conclusion: TB disease in high-risk populations where it is difficult to detect, diagnose, and treat;
limitations of current control measures and the need for new tests and treatments, including an effective
vaccine; improving information system, regulation of individual form and personnel training.
Total Phenol and Antioxidant from Seed and Peel of Ripe and Unripe of Indones...iosrphr_editor
Study on total phenol and antioxidantactivity ofsugar apple fruits of various solvent, part of fruits, and level of ripening. Solvent extraction used were 80% (v/v) methanol, 50% (v/v) acetone, boiling water, and 50% (v/v) ethanol. Part of fruits thatbeen used for samples were seed and peel which are normally by products of sugar apple processing, level of ripening were unripe, and ripe sugar apple fruits. Total phenol was determined by Folin-ciocalteau method. Total antioxidant was quantified by 1,1-diphenyl-2-picrylhydrazyl(DPPH) method.Therewas a difference in type of solvent, part of fruits, and level of ripeningon total phenol and antioxidant concentration of sugar apple fruits. Seeds have higher total phenol concentration than peels of this fruits. Unripe sugar apple fruits have higher total phenol and antioxidant than ripe fruit. The best solvent for phenol extraction was ethanol 50%butthe best solvent for antioxidant extraction was acetone 50%.
A Review on Step-by-Step Analytical Method Validationiosrphr_editor
When analytical method is utilized to generate results about the characteristics of drug related samples it is essential that the results are trustworthy. They may be utilized as the basis for decisions relating to administering the drug to patients. Analytical method validation required during drug development and manufacturing and these analytical methods are fit for their intended purpose. To comply with the requirements of GMP pharmaceutical industries should have an overall validation policy which documents how validation will be performed. The purpose of this validation is to show that processes involved in the development and manufacture of drug, production and analytical testing can be performed in an effective and reproducible manner. This review article provides guidance on how to perform validation characteristics for the analytical method which are utilized in pharmaceutical analysis.
A Cross Sectional Study of Ethnic Differences in Occurrence and Severity of A...iosrphr_editor
Non-steroidal anti-inflammatory drugs are the most widely used "over the counter" medication all over the world despite their complications in different major organs. Present studies envisaged for knowing the occurrence and severity of adverse drug reactions from NSAIDs in different ethnic communities of Sikkim. A cross sectional study was undertaken in the medicine outpatients department of a secondary and tertiary care hospital. The patients belonging to Nepalese, Bhutias, Lepchas ethnic communities and others community (settlers from other parts of India) were included to analyzed the data based on the age and gender, ethnicity and ADRs, drugs and ADRs. Severity assessment was done using Hartwing and Siegel scale and causality assessment by Naranjo scale. Total 109 cases of ADRs, predominating in female were detected. Nepalese were the most affected and Gastrointestinal tract (GIT) being the most affected organ in them. Diclofenac showed maximum number of ADRs in all the communities. Maximum number of cases occurred on single day use (40.36%) of drugs. All the cases were belonging to the "possible category" and the maximum being the mild (72.48%) in nature. It is advisable to consider the ethnic/racial differences equally with other factors, to improve the safety and efficacy of a drug.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
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Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
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Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Factors Affecting Non-Compliance among Psychiatric Patients in the Regional Institute of Medical Sciences, Imphal.
1. IOSR Journal Of Pharmacy
(e)-ISSN: 2250-3013, (p)-ISSN: 2319-4219
www.iosrphr.org Volume 5, Issue 1 (January 2015), PP. 01-07
1
Factors Affecting Non-Compliance among Psychiatric Patients in
the Regional Institute of Medical Sciences, Imphal.
Maan C G 1
, Munnawar Hussain M S 2
, Heramani N 3
, Lenin RK 4
1.
Medical Officer, District Hospital, Churachandpur, Manipur, India.
2.
Senior Resident, Department Of Psychiatry, Vydehi Institute Of Medical Sciences & Research Centre,
Whitefield, Bangalore, Karnataka,India-560066 ,
3.
Professor & Head Dept. Of Psychiatry, Rims, Imphal,
4.
Professor, Dept. Of Psychiatry, Rims, Imphal.
ABSTRACT
AIMS:
This study was carried out with an objective to assess different reasons of medication non-compliance in a
sample of out-door psychiatric patients and to evaluate the correlation between clinical variables and causes of
non-compliance to drugs. This study was conducted at Psychiatry department, Regional Institute of Medical
Sciences; from (30th
Sept 2012 to 31st
Aug 2013) .Data from a non-probability sample of 50 follow-up patients
with a definite psychiatric illness was collected. Patients were recruited who were between 18 and 60 years of
age and who were treated in the outpatient clinics of the psychiatry department. Information regarding socio-
demographic characteristics (e.g., age, gender, level of education, marital status, and income) were recorded on
a proforma designed by the author. A questionnaire designed for this purpose was administered to examine the
factors that cause non-compliance. Data was analyzed using SPSS for window 20.0 version. Chi-square
analysis done for variable of interest. Non-compliance to drug treatment is most common in between 21-30
years of age groups, more in females 72% than males 28%, those who are married(60%) than single(40% ),and
with low education(28%) & low socio-economic status(54%).
Notable reasons for non-compliance were feelings of wellness(26%), paranoia to medication(22%),lack of
insight to the illness(14%),medication side effects(10%),hopelessness of cure & poor support (8%)
respectively.,financial problems (6%), no improvement(4%), too much of medication(2%).
The commonest psychiatric illnesses leading to non-compliance were schizophrenia (26%), BPAD (18%), MDD
(14%), psychosis (10%), epilepsy & OCD (8%) each, GAD (6%), somatization disorder & substance induced
psychosis (4%) each, panic attack with agoraphobia (1%).
Data analyses explored significant associations between age, income and psychiatric illness with causes of non-
compliance to drugs (P<0.01).
CONCLUSION: Non-compliance is quite common in psychiatric patients. Medical practitioners need to be
aware of it and address this problem because compliance is directly related to the prognosis of the illness.
KEY WORDS: Socio-demographic characteristics, non-compliance, psychiatric illness, reasons.
I. INTRODUCTION
Non-compliance can be defined as a discontinuation or failure of proper medication intake without
prior approval from the treating physician In a review article that summarized findings of studies from 1961 to
1975 and commented that failures of patients to compliance with the treatment is a major problem in case of
psychiatric patients.2
By its very nature psychiatric illness that impairs judgment, insight and stability places psychiatric
patients at increased risk for medication non-compliance.
3
Non-compliance of patients with prescribed treatment is considered as a barrier to effective health
care. Non-compliance with prescribed treatment has implications for the health of the patients; the effective use
of resources & assessments of the clinical efficacy of treatment .
It is seen as an important area of concern for all
health care professionals. 4
2. Factors Affecting Non-Compliance Among…
2
Non-compliance contribute to relapse and re-hospitalization 5
.The cost of poor compliance to sufferers
and also to society is considerable and effective ways of improving compliance are a crucial part of good
management 6
Therefore, improving medication compliance in persons with mentally ill holds the potential for
reducing morbidity and suffering of patients and their families, in addition to decreasing the cost of re-
hospitalization7
Physicians contribute to the non-compliance by failing to prescribe simple regimens, not explaining the
benefits and side-effects of medication, not considering patients’ lifestyle or medication cost involved and
inadequately eliciting and rectifying the myths and beliefs held by patients 8
One of the ways to improve drug compliance is to know crucial factors responsible for poor drug compliance so
that proper management strategies may be planned to improve patients’ drug compliance. .
II. MATERIALS & METHOD:
It was a hospital based cross-sectional study. 50 consecutive drug non-compliant psychiatric patients
attending Psychiatry O.P.D, RIMS. Subject aged between 18 to 60 years of either sex. Patients having cognitive
deficit or acute psychosis. Patients presenting for the first time in Psychiatry O.P.D. Patients unable to undergo
the interview and with no informant. An Informed consent was taken from patients and their legal guardians
before conducting the study. A cross sectional study was conducted in those patients attending out-patient
services of Psychiatric Department, RIMS. Basic socio-demographic information along with psychiatric
diagnosis, were recorded in a semi-structured proforma. The different reasons for non-compliance were assessed
through a structured interview using a checklist. Data was analyzed using SPSS for Windows 20.0
Version. Chi–square analysis was done for the variables of interest.
II. RESULTS
Mean age of the patients was 31.40+6.59 years ranging from 18-60years. Mean income was 12120.00+
5913.11 years & mean illness duration was 32.16+23.82 years ranging from (18-60years). Majority of the
subjects (n=29, 58%) were between the age range of 21-30 years. Out of 50 follow-up drug non-compliant
patients (n=36, 72%) were females and (n=14, 28%) males. (60%) were married. Most of them were having low
education up to primary class (n=14, 28%), and belong to low socio-economic status (n=27, 54%). The
commonest psychiatric illnesses leading to non-compliance were schizophrenia (26%) followed by BPAD
(18%) and MDD (14%),psychosis(10%),epilepsy & OCD (8%),GAD (6%),panic disorder & substance induced
psychosis (4%), somatization disorder (1%). Subjective well being (26%),paranoia to medication (22%)were the
two most prevalent causes for non-compliance respectively , no insight into the illness (14%), medication side
effects was perceived to be a contributor of non-compliance in (10%) patients and hopelessness of cure & poor
support was a cause in (8%) patients. Financial problems was reported by (6%), no improvement in (4%), too
much of medication in (2%) of patients. Significant association is found between non-compliance with age,
income and psychiatric diagnosis of the patients (p<0.01).
III. DISCUSSION:
The observation shows that non-compliance is common in the age group (21-30) years. Similarly, other
study has reported young patients under 40 years have a low compliance rate (9, 10)
.Younger patients were found
to have more level of non compliance, this implies that younger patients may have a more negative perception
of medicine, perceiving them to be more harmful and viewing themselves as possessing greater personal control
on how to best manage their condition .11
Among the sex, females (72%) were more non-compliant to
medication than males (28%) which is similar with the findings of Selen yegenoglu et al 12
who reported that
there were more female than male non-compliant patients (61% and 38.9% respectively) About (60%) of
married patients were more non-compliant with medications than unmarried patients. Another study has noted
that non compliant were predominantly unmarried (n=19, 63%) 13
.This is again in contrast with other studies
who reported that married patients were more compliant to medication positively. The help and support from a
spouse and this could be the reason why married patients were more compliant to medication positively than
unmarried patients. 14, 15
Patients up to primary class education (28%) were more non-compliant to medication
similarly other study found that patients with low literacy skills are less likely to be compliant to their
medication regimens. 16
(44%) of Unemployed were noncompliant to medication. This is consistent with other
findings 17, 18
. A study by Bloom et al 19
found that 92% (n=35) of the non compliant were unemployed at the
time of hospital admission. This suggests that noncompliance could have been attributed to their possible
3. Factors Affecting Non-Compliance Among…
3
financial constraints as they might find it difficult to afford visiting their healthcare facility on a monthly basis
and thus, might not have regular refills on their prescription. Patients having an income of <Rs 10,000 (54%)
were more non compliant to medication which is similar with the findings of Berghofer et al20
(44%) of patients were having duration of illness between (1-2years) .This corresponds with the finding of
Rekha et al 21
who reported that longer duration of the illness may adversely affect drug compliance.
Among different psychiatric illness, patients suffering from schizophrenia (26%,n=13) are the commonest not to
comply which correlates with the findings of Victoria Omranifard et al 22
who reported that Schizophrenic
patients has the highest non-compliance rate (27.2%).The findings of the present study shows subjective well
being (26%, n=13) as the most common reason for non-compliance to medication which is consistent with that
reported by previous studies that after resolution of an acute episode ,however, some patients stop medication
because they feel well and therefore no longer in need of treatment.23,24
Paranoia to medication is reported to
cause non-compliance in (22%) of patients which is consistent with the studies of Swett C25
.who reported high
levels of paranoid ideation were significantly associated with premature termination of medication.
No insight to the illness attributed to non-compliance in (14%) of the patients. Mc Evoy et al 26
reported similar
studies showing that psychotic patients; especially the first episodes of psychiatric conditions have little insight
and this is shown to increase the risk of discontinuing medication.
(10%) of the patients were non-compliant due to the side effects of medication mainly sedation and
weight gain. Similarly patients who discontinue prescribed neuroleptic medicine cite side effects as their
primary reason for non-compliance 23
. Selen et al 12
also reported occurrence of physical side effects as the most
frequent reasons for discontinuing medication (8%) reported hopelessness of cure as a cause of noncompliance
to medication .Similarly Victoria Omranifard et al 22
found hopelessness as a cause of non compliance to
medication in (12.8%) of patients. Poor support cause non compliance in 8% of patients. Two studies also
reported lack of emotional support and help from family members and friends as the causes of poor drug
compliance in the patients 27, 21
6% are not compliant to medication due to financial problems. This is in
accordance with that reported by other study.21
4% were non compliant to medication due to no improvement in
the medication. Similarly 7% reported no improvement as a cause of non compliant to medication.21
2% of the non compliant were due to too much of medication. Similarly (1.2%) were not compliant due to too
much of medication as reported by Victoria Omranifard et al. 22
In this study, age is significantly associated with non compliance (P<0.01).Similarly, age is found to
have significant association with low compliance which is similar with the finding reported by previous study. 28
Marital status is found to have significant association with non compliance (P<0.05). Similarly, Zito et al 29
reported unmarried having significant association with poor compliance. An association is present between
income and causes of non-compliance .This corresponds to the findings of Hoge et al 30
who found that in their
urban‐based hospital there is a strong relationship between non compliance and social class with those coming
from the lower socio‐economic class. A correlation is present between non compliance and psychiatric diagnosis
(P<0.01).Two studies found that non compliance to medication were likely to be diagnosed with bipolar
disorder and schizoaffective disorder, while majority of consenting patients had a diagnosis of schizophrenia. 29,
31
These findings are however supported by other studies who found the most common diagnosis among non
compliance of medication was schizophrenia.32, 33
IV. CONCLUSION:
In this study it is found that the factors contributing to noncompliance in psychiatric patients are age 21-30
years, female sex, married, having low level of education, unemployed, income <Rs 10,000,with 1-2 years
illness duration. Schizophrenia was the commonest psychiatric illness leading to noncompliance. The
commonest reasons for noncompliance are feeling of subjective well being, paranoia to medication, no insight
into the illness, medication side effects, hopelessness of cure, lack of care giver/poor support, financial
problems, no improvement, too much of medication etc.
This study stresses the critical need for taking necessary steps toward minimizing poor outcomes related to lack
of compliance in drug therapy. There were some limitations in this study. Sample size is small. Study is
confined to a tertiary hospital, which may not necessarily represent the general population of the country. Recall
bias associated with self reporting. And, treatment variables such as medication and its doses or poly-pharmacy
were not assessed.
4. Factors Affecting Non-Compliance Among…
4
There is a need to provide proper counseling to patients and their caregivers regarding nature of illness
better explanation of duration of use of medication , associated side-effects as well as elaborately discussing
consequences of non –compliance. Studies on socio demographic and clinical correlates of drug non-compliance
will add more information into our understanding of non compliance by psychiatric patients. It is recommended
that further research is needed in this field to know more about it and to understand it better. Medical
practitioners need to be aware of it and address this problem because compliance is directly related to the
prognosis of the illness.
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5. Factors Affecting Non-Compliance Among…
5
Table 1 – Demographic features of the patients
Socio-demographic Factor
Mean + S.D.
Age (in years) 31.40 + 6.59
Income (in Rs) 12120.00 + 5913.11
Illness duration
32.16 + 23.82
Age groups
Age groups No .of cases (%)
10-20years 4(8%)
21-30years 29(58%)
31 & above 17(34%)
Sex
Sex No. of Cases (%)
Male 14(28%)
Female 36(72%)
Marital status - Status No. of Cases (%)
Single 14(28%)
Married 36(72%)
Spouse death 1(2%)
Divorce 5(10%)
Educational status - Status No. of Cases(%)
Illiterate 6(12%)
Literate 44(88%)
Primary 14(28%)
Class X 9(18%)
Class XII 11(22%)
Graduate 10(20%)
Occupation Unemployed 22(44%)
Employed 7(14%)
Students 4(8%)
Duration of illness Less than 1year 8(16%)
1-2years 22(44%)
3-4years 12(24%)
5-7years 8(16%)
Fig 1: NON-COMPLIANCE AND PSYCHIATRIC ILLNESS
6. Factors Affecting Non-Compliance Among…
6
Fig2: Reasons for non-compliance
Table 2: Age of the patients and the causes of non-compliance
Ho: There is independence of age and non-compliance of the patients.
Chi-Square Tests
Value df Asymp. Sig. (2-
sided)
P-value
Pearson Chi-Square 185.343 136 0.003** P<0.01
No. of Valid Cases 50
*Significant at 0.05 probability level.
** Significant at 0.01 probability level.
Since P<0.01, the null hypothesis Ho is rejected at 0.01 probability level of significance and hence non-
compliance is associated with age of patients.
Table 3. Marital status of the patients and causes of non-compliance.
H0: There is independence of marital status and non-compliance of the patients.
Chi-Square Tests
*Significant at 0.05 probability level.
** Significant at 0.01 probability level
Since P<0.05, the null hypothesis H0 is rejected at 0.05 probability level of significance and hence non-
compliance is associated with marital status of the patients.
Value df Asymp.Sig .(2-
sided)
P-value
Pearson Chi-Square 39.982 24 0.021* P<0.05
No. of Valid Cases 50
7. Factors Affecting Non-Compliance Among…
7
Table 4: Income of the patients and the causes of non-compliance
Ho: There is independence of income and non-compliance of the patients.
Chi-square tests
Value df Asymp. Sig. (2-
sided)
P-value
Pearson Chi-Square 175.243 128 0.004** P<0.01
No. of Valid Cases 50
*Significant at 0.05 probability level.
** Significant at 0.01 probability level.
Since P<0.01, the null hypothesis Ho is rejected at 0.01 probability level of significance and hence non-
compliance is associated with income of patients.
Table 5: Psychiatric diagnosis and causes of non-compliance.
H0: There is independence of psychiatric diagnosis and non-compliance of the patient.
Chi-square tests
Value df Asymp.Sig.(2-sided) P-value
Pearson Chi-Square 132.167 72 0.000** P<0.01
No. of Valid cases 50
*Significant at 0.05 probability level
**Significant at 0.01 probability level
Since P<0.01, the null hypothesis HO is rejected at 0.01 probability level of significance & hence non-
compliance is associated with psychiatric diagnosis of the patients.