This overview includes 21 SRs on 313 individual primary studies in a broad spectrum of chronic conditions. Provided by the Springer Nature SharedIt content-sharing initiative. Hypertension. Teach the patient in identifying modifiable risk factors such as obesity, high-sodium and fat diet, sedentary and stressful lifestyle, smoking, and daily alcohol drinking of more than 2 oz per day. volume8, Articlenumber:112 (2019) 2014;67(10):107682. Factors associated with medication adherence among patients with diabetes in the Middle East and North Africa region: a systematic mixed studies review. top mum influencers australia LIVE St. Louis, MO: Elsevier. Given the considerable amount of literature in this field, this updated overview provides a current and compact overall view on this topic. Crawshaw J, Auyeung V, Norton S, Weinman J. Identifying psychosocial predictors of medication non-adherence following acute coronary syndrome: a systematic review and meta-analysis. 4. This overview analyses factors that might impact adherence to oral therapies in adult patients with physical chronic diseases. Desired Outcome: The patient will verbalize understanding of the condition, prognosis, and potential complications or the medical condition along with the therapeutic needs, and the patient will adequately perform necessary procedures and rationalize reasons for actions. Some evidence for a positive impact was exclusively noted in HIV-infected patients [32, 34]. A list of excluded studies is available in Additionalfile2. Therapy-related factors (e.g., intake regime) and disease-related factors (e.g., duration) mostly showed no impact on adherence. government site. Please enable it to take advantage of the complete set of features! We rated eight SRs to be at low risk of bias and 13 to be at high risk of bias. Therefore, on the one hand, we believe that our results are widely applicable for implementation adherence to oral drugs in physical chronic diseases. A collaborative relationship, agreement on treatment tasks, and stability of the alliance are necessary elements of better treatment adherence. Handbook of research synthesis and meta-analysis. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. Dtsch Med Wochenschr. Marital status was investigated in the SRs on Parkinson disease, inflammatory arthritis, chronic diseases, HIV, patients taking oral anticancer agents and cardiovascular conditions. The psychomotor domain, on the other hand, consists of physical skills and procedures. Gemeda DH, Gebretsadik LA, Dejene T, Wolde M, Sudhakar M. Determinants of non-compliance with antiretroviral therapy among adults living with HIV/AIDS: a systematic review. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Int J Cardiol. Terms and Conditions, Cancer Epidemiol. Include the patient in their plan.Telling a patient what they should or shouldnt do will not necessarily guarantee adherence. Please read our disclaimer. It was uncertain whether health insurance status (insured vs. uninsured) influences adherence in patients with chronic or cardiovascular conditions [23, 25]. The nurse must first assess if the patient is ready to learn by assessing their interest, emotional status, and mental capacity for learning. Risk of bias in the systematic reviews. Google Scholar. Assess readiness to learn. Inform the patient about having specific limited activities. Upon eating bland and small amounts of food with water, instruct the patient to remain in upright position 1-2 hours after meal, and avoid eating 2-4 hours before bedtime. Food like dark-green leafy vegetables, fish, meat, poultry, eggs, milk, and fortified breakfast meals are sufficient to replenish the body with nutrients needed for hematopoiesis. In patients taking oral anticancer agents, there was some evidence that middle-aged people (approximately 4560) are more adherent than very old (>75years) and younger people (<45years) [28]. 1. We used the Risk of Bias in Systematic Reviews (ROBIS) tool to assess the included SRs [16]. Second, we used modified vote counting; however, we are aware that this type of methodology has strong limitations. The explanation for the inconsistent results of the linear analyses might also be attributed to the fact that the association is indeed non-linear. A knowledge deficit is a nursing diagnosis that happens when a patient doesn't have the information or the ability to understand the information necessary to continue their health care plan. knowledge deficit related to medication compliance. official website and that any information you provide is encrypted We included 21 SRs on eight different conditions. In . A discrete choice experiment in a community sample in Australia. Bazargan M, Smith J, Yazdanshenas H, Movassaghi M, Martins D, Orum G. BMC Geriatr. The ROBIS tool was applied by two independent reviewers (TM, AG). In cardiovascular conditions, some evidence exists that a higher socioeconomic status has a positive impact on adherence [29]. Consider cultural factors.Some cultures value strong familial influence and defer to older or male relatives for health decisions. The evidence synthesis of the analysed factors (according to the different diseases/therapies) is presented in Table3. The evidence synthesis indicates that belonging to an ethnic minority seems to be associated with reduced adherence. PLoS One. Virtually all fractures require casts, splints, or braces during healing, so it is strictly recommended to use them especially if the patient needs to move in order to prevent damage and compromised healing. The evidence for an impact was uncertain in oral-anticancer agents [39]. 2008;11(1):447. 2014;72(1):37. Some evidence for higher adherence in women was noted exclusively in cardiovascular conditions [21, 23, 33, 37]. A. Sensory-perceptual alteration related to withdrawal into self. Heart Lung. 3. We anticipated that these parameters would lead to a higher sensitivity compared with the search for the previous overview version. The https:// ensures that you are connecting to the Therefore, strict and motivated follow-up appointments followed by faithful adherence to medications are helpful in reducing the impact and complication of hypertension. By using this website, you agree to our https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/health-literacy, Impaired Physical Mobility Nursing Diagnosis & Care Plan, Chronic Pain Nursing Diagnosis & Care Plan, Unfamiliarity with subject (new diagnosis or treatment), Inaccurate demonstration or teach-back of instructions, Exhibiting aggression or irritability regarding teaching follow-up, Poor adherence or worsening medical condition, Avoiding eye contact or remaining silent during teaching, Patient will identify risk factors of their disease process and how to prevent worsening of symptoms, Patient will participate in the learning process, Patient will demonstrate the proper execution of, Patient will identify barriers to their learning and how to overcome. Deficient knowledge about medications Physical impairment Mental impairment Insufficient/lack of support Deteriorating health status Lack of financial resources Unwillingness to implement necessary changes Engagement in risky behavior that worsens health Unhealthy lifestyle choices Smoking Illicit drug use Poor diet Lack of exercise Patients over age 65 have a lower health literacy than those of younger ages. We analysed seven potentially socioeconomic adherence-influencing factors. The nurse's ongoing assessment and understanding of the patients' reasons for treatment resistance is the key to promoting medication compliance. Available from: URL: http://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf;jsessionid=5533CE0804BE2E0722B919623C4C2E05?sequence=1.Assessed 28.11.2018. We and our partners use cookies to Store and/or access information on a device. Nursing care plans: Diagnoses, interventions, & outcomes. Bull World Health Organ. F. A. Davis Company. Manage Settings 2003;12(4):298303. TM was an author of two of the included SRs. (Select all that apply. Discuss the significance of consistent clinical or therapy follow-up appointments to the patient. Nurses Pocket Guide Diagnoses, Prioritized Interventions, and Rationales (11th ed.). 2018;8(1):e016982. Nachega JB, Uthman OA, Peltzer K, Richardson LA, Mills EJ, Amekudzi K, et al. The influence of health systems on hypertension awareness, treatment, and control: a systematic literature review. witoniowska-Lonc N, Polaski J, Mazur G, Jankowska-Polaska B. Int J Environ Res Public Health. Pieper D, Antoine S-L, Mathes T, Neugebauer EAM, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. Assess health literacy.Health literacy affects a patients ability to comprehend and process health-related material. A combination of support, guidance, and empathy can increase the patients success in achieving a complete lifestyle change. Compared with the previous version, we narrowed the scope by considering only factors for which there were some indices for an influence in the previous broad overview [12]. The evidence indicates that socioeconomic status and social support might have a positive impact on adherence and that belonging to an ethnic minority might have a negative impact on adherence. MeSH Qual Saf Health Care. J Clin Epidemiol. 2017 Jul 25;17(1):163. doi: 10.1186/s12877-017-0558-5. Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2008). Identify the support person or caregiver that will benefit the most from teaching. Anna Curran. It would be prudent to educate the patient about the presence of hypertension, as well as giving insights of the possible change in lifestyle. Full and consistent cooperation of the patient in regimen reduces risk of getting adverse reactions from surgery such as bacterial infections or severe pain on the surgical site. provides robust evidence for a negative impact of co-payments on adherence across different conditions [40]. 2013;18(4):40927. Gast, A., Mathes, T. Medication adherence influencing factorsan (updated) overview of systematic reviews. The main cause for downgrading due to imprecision was insufficient reporting, which prevented us from adequately assessing the results. 5. Nursing Diagnosis: Deficient Knowledge related to lack of exposure/recall, new condition or treatment, or unfamiliarity with the disease condition secondary to anemia as evidenced by inaccurate follow-through of instructions and verbalized inaccurate information. Medication adherence: WHO cares? Desired Outcome: The patient will verbalize ones understanding of disease process and possible treatment plan, as well as the familiarity of the drug adverse effects and possible complications. Have the patient learn by assessing current knowledge on the diagnosis, disease process, possible aggravating factors, and necessary treatment. Moreover, keeping the device/s dust- and contaminant-free reduces the risk of infection at the fractured area. Nevertheless, we decided to use modified vote counting because we anticipated that this is the only method to harmonize the results from different types of narrative synthesizes. The following conditions and medications were considered: chronic non-malignant pain [35], cardiovascular diseases (e.g., coronary artery disease, hypertension, diabetes mellitus) [21,22,23,24,25,26, 29, 30, 33, 37], Parkinson disease [36], hepatitis C [27], oral anticancer agents [28, 39], inflammatory arthritis [38], HIV/AIDS [31, 32, 34] and chronic diseases [20]. All data were extracted using standardized extraction forms piloted beforehand. 2012;18(10):105361. The moderate to high risk of bias in the included SRs and the exclusion of 78 reviews due to missing quality assessment of included primary studies indicate that there is a need for more methodically sound research to provide stronger conclusions. Creating a plan that fits the clients lifestyle will ensure the highest chance of adherence and motivation. 2009;151(4):264. 2017;129:115. select all that apply: A. isolation B. daily activities C. consistency D. medications E. adequate rest D, E Assess the patients current knowledge about hypertension and obstacles to learning.
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