Medication Adherence and Belief about Medication among Vietnamese Patients with Chronic Cardiovascular Diseases Within the Context of Implementing Measures to Prevent COVID-19

Background: Long-term adherence is crucial for optimal treatment outcomes in chronic cardiovascular diseases (CVDs), especially throughout the COVID-19 wide-spreading periods, making patients with chronic CVDs vulnerable subjects. Aim: To investigate the relationship between the characteristics, beliefs about prescribed medication, COVID-19 prevention measures, and medication adherence among patients with chronic CVDs. Methods: This is a cross-sectional study of outpatients with chronic CVDs in Southern Vietnam. The specific parts regarding the Beliefs about Medicines Questionnaires (BMQ-Specific) and the General Medication Adherence Scale (GMAS) were applied to assess the beliefs about and adherence to medication. The implementation measures to prevent COVID-19 in patients were evaluated according to the 5K message (facemask, disinfection, distance, no gathering, and health declaration) of the Vietnam Ministry of Health. A multivariable logistic regression with the Backward elimination (Wald) method was used to identify the associated factors of medication adherence. Results: A slightly higher score in BMQ-Necessity compared to BMQ-Concerns was observed. A total of 40.7% of patients were recorded as having not adhered to their medications. Patients' behavior was most frequently self-reported by explaining their non-adherence (34.7%). Statistical associations were found between rural living place, unemployment status, no or only one measure(s) of COVID-19 prevention application, and medication adherence. Conclusion: During the COVID-19 spreading stage, patients generally showed a positive belief about medication when they rated the importance of taking it higher than its side effects. The data analysis suggested that rather than patients’ beliefs, the clinicians should consider the patient factors, including living place, employment, and the number of epidemic preventive measures applied for guiding the target patients for improving medication adherence

Pharmacist-Led Interventions to Reduce Drug-Related Problems in Prescribing for Pediatric Outpatients in a Developing Country:A Randomized Controlled Trial

OBJECTIVE To evaluate a pharmacist-led intervention’s effectiveness in reducing drug-related problems (DRPs ) related to prescriptions for pediatric outpatients. METHODS We conducted a randomized controlled trial. We recruited and randomly assigned 31 physicians to control or intervention groups. We collected 775 prescriptions (375 from the control group and 400 from the intervention group) at the start. For 3 weeks, intervention physicians received additional information and meetings with pharmacists in addition to the usual practices of the hospital. We then collected prescriptions at the end of the study. We classified DRPs, based on reliable references (Supplemental Table S1) at baseline and endpoint (a week after the intervention). The primary outcome was the proportion of prescriptions with DRPs, and secondary outcomes were the proportions of prescriptions with specific DRP types. RESULTS The influence of the intervention on general DRPs and specific DRPs was the study’s main finding. The pharmacist-led intervention helped reduce the prescriptions with DRPs proportion in the intervention group to 41.0%, compared with 49.3% in the control group (p &lt; 0.05). The DRPs proportion related to the timing of administration relative to meals, unlike the other DRP types, increased in the control group (from 31.7% to 34.9%) and decreased in the intervention group (from 31.3% to 25.3%), with a significant difference between the 2 groups at endpoint (p &lt; 0.01). Patients aged &gt;2 to ≤6 years (OR, 1.871; 95% CI, 1.340–2.613) and receiving ≥5 drugs (OR, 5.037; 95% CI, 2.472–10.261) were at greater risk of experiencing DRPs related to prescribing. CONCLUSIONS A pharmacist-led intervention improved DRP occurrence related to physicians’ prescribing. Pharmacists could be involved in in-depth research with physicians in the prescribing process to provide tailored interventions.</p

Medication Adherence in Vietnamese Patients with Cardiovascular and Endocrine&ndash;Metabolic Diseases

(1) Background: COVID-19 has significantly affected the quality of life and the medication adherence of patients with chronic diseases. Attitudes towards the disease and preventive measures are the things that need to be considered for patient adherence to medication during the COVID-19 pandemic. We aimed to evaluate the rate and compare the medication adherence and the impact of the COVID-19 pandemic on medication adherence in Vietnamese patients with cardiovascular and endocrine&ndash;metabolic diseases. (2) Methods: A cross-sectional study was conducted on outpatients having chronic diseases such as cardiovascular or/and endocrine&ndash;metabolic diseases in some southern provinces in Vietnam. In each group of patients, medication adherence was measured and assessed with the General Medication Adherence Scale (GMAS), adjusted and validated in Vietnam. In addition, the study also investigated attitudes and practices to prevent COVID-19. (3) Results: Out of 1444 patients in our study, the level of adherence was recorded in 867 cases, accounting for 61.1%. The group of patients with only cardiovascular disease and patients with only endocrine&ndash;metabolic disease had relatively similar compliance rates of 62 and 61.1%, respectively. The leading cause of non-adherence to treatment in all three groups of patients in the study, as assessed by the GMAS, was non-adherence due to financial constraints. Our study showed that 71.6% of patients felt anxious when going to the hospital for a medical examination. However, only 53.7% identified the COVID-19 pandemic as obstructing treatment follow-up visits. The research results showed that the COVID-19 epidemic influences the patient&rsquo;s psychology with regard to re-examination and treatment adherence, with p coefficients of 0.003 and &lt;0.001, respectively. (4) Conclusion: Medication adherence rates in two disease groups are close, and financial constraint is the fundamental reason for medication non-adherence. Regulatory agencies must take care of people&rsquo;s welfare to improve adherence in the epidemic context

Medication Adherence of Vietnamese Outpatients with Chronic Diseases during the COVID-19 Pandemic

The purpose of this study was to determine the medication adherence of outpatients with chronic diseases and the association between both patient attitudes and preventive practices regarding COVID-19 and their medication adherence. We performed a cross-sectional study in Vietnam. Medication adherence was determined using the translated and validated Vietnamese version of the General Medication Adherence Scale (GMAS). Patient attitudes and preventive practices regarding COVID-19 were measured using the 5K message of the Vietnam Ministry of Health (facemasks, disinfection, distance, no gatherings, health declarations). The associations between patient characteristics and medication adherence were determined by multivariable regression. The study included 1852 outpatients, and 57.6% of the patients adhered to their medications. Patients who recognized the pandemic&rsquo;s obstruction of medical follow-ups (OR = 1.771; 95%CI = 1.461&ndash;2.147; p &lt; 0.001), who applied &ge;2 preventive methods (OR = 1.422; 95%CI = 1.173&ndash;1.725; p = 0.001), who were employed (OR = 1.677; 95%CI = 1.251&ndash;2.248; p = 0.001), who were living in urban areas (OR = 1.336; 95%CI = 1.090&ndash;1.637; p = 0.005,) who possessed higher education levels (OR = 1.313; 95%CI = 1.059&ndash;1.629; p = 0.013), or who had &le;2 comorbidities (OR = 1.293; 95%CI = 1.044&ndash;1.600; p = 0.019) were more likely to adhere to their medications. The adherence percentage for outpatients with chronic diseases was quite low during the pandemic. Patients who did not recognize the COVID-19 pandemic&rsquo;s obstruction of medical follow-ups or who had poor preventive practices were less likely to adhere to medications. Healthcare providers should pay more attention to these groups to achieve desired treatment outcomes