Factors associated with therapeutic non-adherence in renal transplant patients: a bicentric study in Algeria / Facteurs associés à la non-observance thérapeutique chez les patients greffés rénaux : une étude bicentrique en Algérie

Introduction: Medication non-adherence is a global concern, particularly in the context of renal transplantation, where it leads to graft failures, increased hospitalizations, diminished quality of life for patients, and higher healthcare costs. The aim of this study was to assess the level of therapeutic adherence among Algerian kidney transplant recipients and identify potential influencing factors. Methods: A descriptive, cross-sectional bicenter study was conducted among kidney transplant patients receiving outpatient care at two specialized medical centers in Algeria: the Urology Department of the Hospital Establishment for Urology, Nephrology, and Renal Transplantation in Constantine, and the Nephrology and Renal Transplantation Department of the University Hospital Center (CHU) in Blida, spanning from January to December 2022. Therapeutic adherence was assessed using the 8-item Morisky questionnaire, while the level of knowledge was analyzed through a 12-item questionnaire. Logistic regression was used to identify factors associated with non-adherence to therapy. Results: This study included 130 patients with an average age of 47 years and a sex ratio of 1.7. The results revealed therapeutic non-adherence in 40.8% of the patients. Multivariate analysis identified several potentially associated factors, including residence, unemployment status, lack of affiliation with a health insurance fund, the use of a therapeutic regimen involving triple therapy, the occurrence of adverse effects, limited education level, and insufficient disease knowledge. Furthermore, non-adherence was associated with an increased risk of graft rejection. Conclusion: The findings of this study highlight concerning therapeutic adherence among kidney transplant recipients, emphasizing the crucial importance of therapeutic education to improve treatment adherence and underscoring the need to integrate these factors into clinical patient management.

Introduction: La non-observance thérapeutique est un problème mondial préoccupant, notamment dans le contexte de la transplantation rénale où elle entraîne des échecs de greffe, une augmentation des hospitalisations, une détérioration de la qualité de vie des patients et des coûts de santé accrus. Cette étude avait pour objectif d'évaluer le niveau d'observance thérapeutique chez les transplantés rénaux algériens et d'identifier les facteurs qui pourraient l'influencer. Méthodes: Une étude descriptive transversale bicentrique a été menée auprès de patients transplantés rénaux suivis en ambulatoire dans deux centres médicaux spécialisés en Algérie : le service d'urologie de l'Établissement hospitalier spécialisé (EHS) en urologie, néphrologie et transplantation rénale de Constantine ainsi que le service de néphrologie et transplantation rénale du Centre hospitalier universitaire (CHU) de Blida, sur une période allant de janvier à décembre 2022. L'observance thérapeutique a été évaluée à l'aide du questionnaire à 8 items de Morisky, tandis que le niveau de connaissance a été analysé à travers un questionnaire de 12 items. La régression logistique a été utilisée pour identifier les facteurs associés à la non-observance thérapeutique. Résultats: Cette étude a inclus 130 patients présentant un âge moyen de 47 ans et un sex ratio de 1,7. Les résultats ont révélé une non-observance thérapeutique chez 40,8 % des patients. L'analyse multivariée a permis d'identifier plusieurs facteurs potentiellement associés à cette non-observance, notamment le lieu d'habitation, le statut de chômage, l'absence d'affiliation à une caisse d'assurance maladie, l'utilisation d'un schéma thérapeutique incluant une trithérapie, la survenue d'effets indésirables, le niveau d'éducation limité et une connaissance insuffisante de la maladie. En outre, la non-observance a été associée à un risque accru de rejet de greffe. Conclusion: Les résultats de cette étude révèlent une observance thérapeutique préoccupante chez les transplantés rénaux, soulignant l'importance cruciale de l'éducation thérapeutique afin de l'améliorer et mettant en évidence la nécessité d'intégrer ces facteurs dans la gestion clinique des patients.

Diseño de una herramienta para la clasificación de pacientes en base a su actitud farmacoterapéutica / Design of a tool for classifying patients based on their pharmacotherapeutic attitude

Introducción: la percepción y alivio del dolor exhiben variabilidad entre individuos. Edad, género, etnia, nivel educativo, nivel real de estrés, estado de ánimo o las condiciones médicas pueden modificar la interpretación personal del dolor y las respuestas al tratamiento farmacológico. Estas diferencias pueden desempeñar un papel significativo en los efectos, en ocasiones no deseados, del tratamiento analgésico.Objetivos: definir perfiles tipo de pacientes con Síndrome de Espalda Fallida ante actitudes con la enfermedad, el tratamiento, la asistencia sanitaria y el seguimiento que reciben de sus profesionales sanitarios. Crear herramienta para la identificación del perfil de paciente.Material y métodos: estudio de series de casos clínicos, observacional, descriptivo y transversal. Población de estudio: pacientes Unidad Dolor Hospital Universitario Nuestra Señora de La Candelaria (HUNSC) en Tenerife en 3 fases: recopilación datos historia clínica (F0), visita inicial (F1) y entrevista personal (F2).Resultados: se obtienen 5 tipologías de pacientes según las respuestas a 17 ítems. A partir de estas respuestas, se calculan ecuaciones de regresión para predecir el tipo de paciente. Se agrupan en: “Clásicos”, “Dependientes”, “Críticos”, “Inconscientes” y “Responsables”. Por otro lado, se obtienen dos herramientas con 17 ítems y otra con 7 ítems optimizados a fin de simplificar el proceso.Conclusiones: estas herramientas permiten a la Farmacia Comunitaria (FC) identificar a los pacientes en función de sus características con el fin de poder dirigir estrategias personalizadas para cada uno de ellos.(AU)

Quality of life, adherence to voice rehabilitation therapy and psychological variables in patients with head and neck cancer / Calidad de vida, adherencia al tratamiento de rehabilitación de voz y variables psicológicas en pacientes con cáncer de cabeza y cuello

Introduction: Voice problems can affect quality of life (QoL), other psychological aspects, and the adequate adherence to voice rehabilitation therapy. Objective: To determine the association between QoL and treatment adherence (TA) to voice rehabilitation with symptoms of anxiety, depression, and coping strategies. Method: A longitudinal study was conducted with 97 participants with head and neck cancer (H&N) who were attending voice rehabilitation therapy. Instruments: EORTC QLQ-C30 and QLQ-H&N35, Treatment Adherence Checklist, Cancer Coping Questionnaire and HADS. Results: The mean overall QoL was 83.33, and mean TA was 8.80. Lower overall QoL and emotional functioning scores, as well as higher dry mouth scores were associated with higher levels of anxiety. Greater problems with social contact and lower TA were associated to higher depression scores. Conclusion: Consistent with the literature, TA and QoL were associated to depression and QoL was also correlated to anxiety. These results are among the first to explore such aspects in Latino patients and emphasize the importance of multidisciplinary care for H&N cancer patients in voice rehabilitation therapy, given that during their treatment they may encounter psychological barriers that could hinder their progress in voice quality and QoL.(AU)

Introducción: Los problemas de la voz pueden afectar la calidad de vida (CV) y otros aspectos psicológicos, así como la adecuada adherencia a la terapia de rehabilitación de voz. Objetivo: Determinar la relación entre la CV y la adherencia al tratamiento (AT) de rehabilitación de voz con síntomas de ansiedad, depresión y estrategias de afrontamiento. Método: Se realizó un estudio longitudinal en 97 participantes con cáncer de cabeza y cuello (CyC) que asistían a terapia de rehabilitación de voz. Instrumentos: EORTC QLQ-C30 y QLQ-H&N35, Lista de Verificación de Adherencia al Tratamiento, la Escala de Afrontamiento al Cáncer y la HADS. Resultados: La CV global promedio fue de 83.33 y el puntaje promedio de AT fue de 8.80. La calidad de vida global, la función emocional y boca seca se asociaron con la ansiedad. La dimensión de la CV contacto social y la AT tuvieron relación con la depresión. Conclusiones: Consistente con la literatura la AT y la CV tuvieron relación con la depresión y solo la CV se relacionó con la ansiedad. Los resultados presentados son de los primeros en explorar estos aspectos en pacientes latinos y enfatizan la importancia de la atención multidisciplinaria a pacientes con cáncer de CyC en terapia de rehabilitación de voz, dado que en el curso de sus tratamientos pueden encontrar barreras psicológicas que obstaculicen la mejora en la calidad de la voz y la CV.(AU)

Estado nutricional y adherencia a la dieta mediterránea en la población escolar de laciudad de Mataró (Cataluña, España) / Nutritional status and adherence to the Mediterranean diet in the school population of the city of Mataró (Catalonia, Spain)

Introducción: existe una disminución de la adherencia a la dieta mediterránea (DM) y un aumento de la prevalencia del exceso de peso entre la población infantil y juvenil española. Objetivos: el objetivo del presente estudio fue conocer el grado de adherencia a la DM y el estado nutricional de la población escolar de Mataró (España) a fin de obtener información útil para el diseño y aplicación de futuras intervenciones. Material y métodos: se realizó un estudio descriptivo de tipo transversal en una muestra de 1177 escolares de entre 6 y 18 años. Se utilizó el índice KIDMED para evaluar la adherencia a la DM y el índice de masa corporal (IMC) para valorar el estado nutricional. Se incluyeron preguntas relacionadas con la percepción de los estudiantes del acceso a alimentos no saludables, la disponibilidad de dinero y el interés de los padres en recibir educación sobre alimentación. Resultados: el porcentaje de niños y adolescentes con óptima adherencia a la DM no alcanza el 50 %, siendo los jóvenes de secundaria quienes presentan un porcentaje menor (30 %). En relación con el estado nutricional de la muestra, más del 70 % presentaron un estado nutricional normal según el IMC, y un 20,7 % de los alumnos de primaria y un 13,8 % de los de secundaria se clasificaron con exceso de peso. Conclusiones: los datos confirman el interés de diseñar e implementar acciones educativas que involucren tanto a los estudiantes como a los padres, con el objetivo de mejorar los hábitos alimentarios de la población. Los resultados sugieren que la disponibilidad de dinero puede facilitar el acceso a alimentos no saludables y, por consiguiente, se debe considerar la promoción de entornos saludables que aumenten la oferta de alimentos saludables.(AU)

Background: there is a decrease in adherence to the Mediterranean diet (MD) and an increase in the prevalence of excess weight among the Spanish child and adolescent population. Objectives: the objective of the present study was to determine the degree of adherence to MD and the nutritional status of the school population of Mataró (Spain) in order to obtain useful information for the design and application of future interventions. Material and methods: a cross-sectional descriptive study was carried out in a sample of 1177 schoolchildren between 6 and 18 years of age. The KIDMED index was used to assess adherence to MD, and the body mass index (BMI) to assess nutritional status. questions were related to the students' perception of access to unhealthy foods, availability of money and parental interest in receiving nutrition education. Results: the percentage of children and adolescents with optimal adherence to MD does not reach 50 %, with secondary school youths presenting a lower percentage (30 %). Regarding the nutritional status of the sample, more than 70 % had a normal nutritional status according to their BMI, and 20.7 % of primary school students and 13.8 % of secondary school students were classified as overweight. Conclusions: the data confirm the interest of designing and implementing educational actions involving both students and parents, with the aim of improving the eating habits of the population. The results suggest that availability of money may facilitate access to unhealthy foods and, therefore, the promotion of healthy environments that increase the supply of healthy foods should be considered.(AU)

Beyond Therapeutic Adherence: Alternative Pathways for Understanding Medical Treatment in Type 1 Diabetes Mellitus.

Given the psychosocial and economic costs of behaviors of patients who seem not to benefit from the medications, technologies, and medical therapies available for chronic diseases such as Type 1 Diabetes Mellitus, therapeutic adherence has been identified as one of the main focuses in the intervention. This paper presents contributions from semiotic cultural clinical psychology for understanding problems associated with the implementation of medical treatment in patients with Type 1 Diabetes Mellitus to explore psychological dimensions not yet reported in depth. A narrative review of 24 scientific articles published between 2012 and 2023 is carried out. The information is produced through thematic analysis, and the results are presented in three themes: 1. illness characteristics, 2. adherence and associated concepts, and 3. modes of intervention. It concludes with the development of a two-axis proposal for understanding the experience of patients that privileges psychological aspects involved in the disease and its treatment, considering the approach to the goals of treatment as dynamic and fluctuating rather than as final states.

Influencia de la adherencia a la dieta mediterránea y del estado nutricional en la reserva ovárica / Influence of adherence to a mediterranean diet and nutritional status on ovarian reserve

Fundamentos: actualmente, la esterilidad afecta a entre el 15% y 20% de las parejas en edad fértil. El éxito reproductivo feme-nino está determinado fundamentalmente por la edad y la reserva ovárica (ro). Recientes estudios remarcan la influencia de factores modificables como los hábitos dietéticos y el estado nutricional en la ro. A este respecto, la dieta mediterránea (dm) se postula como un estándar de alimentación saludable. Por ende, el objetivo de este estudio fue analizar la influencia de la adherencia a la dm y el estado nutricional en la ro de mujeres estériles. Métodos: se efectuó un estudio descriptivo transversal, de un año de duración, entre los meses de febrero de 2022 y febrero de 2023, en una muestra de cuarenta y cinco pacientes de sexo femenino que acudieron a la consulta de ginecología-esterilidad en el hospital marina salud de denia (españa) por deseo genésico mayor a un año. Se realizó un análisis descriptivo de carácter exploratorio basado en una estadística univariable. Resultados: el estudio incluyó una muestra total de cuarenta y cinco mujeres (n=45) siendo la media de edad de 31,84 (±3,99) años, siendo el imc medio de 26,27 (±6,08) kg/m2, teniendo el 44,4% (n=20) un imc por encima de los valores normales. En cuanto a la ro, se midió en base a la amh, siendo el valor promedio de 2,32 (±1,59) ng/ml, y al rfa, siendo la media de 19,80 (±14,13) folículos antrales. Se encontró una asociación estadísticamente significativa entre la baja adherencia a la dm y menores niveles de hormona antimülleriana (amh; p=0,025). Además, se determinó una asociación entre el bajo consumo de verduras y hortalizas (p=0,044), el excesivo consumo de carne roja (p=0,027) y de bebidas carbonatadas (p=0,015) con insuficientes niveles de amh, indicativos de baja ro...(AU)

Background: currently, esterility affects between 15% and 20% of couples of fertile age. Female reproductive success is mainly determined by age and ovarian reserve (or). Recent studies highlight the influence of modifiable factors such as dietary habits and nutritional status on or. In this regard, the mediterranean diet (md) is postulated as a standard of healthy eating. Therefore, the objective of this paper was to analyze the influence of adherence to dm and nutritional status on the or of infertile women.methods: a descriptive cross-sectional study was carried out, lasting one year, between february 2022 and february 2023, in a sample of forty-five female patients who attended the gynaecology-esterility consultation at the marina salud hospital in denia (spain) due to genital desire older than one year. An exploratory descriptive analysis based on univariate statistics was performed.results: the mean age of the sample (n=45) was 31.84 (±3.99) years, with an average bmi of 26.27 (±6.08) kg/m2, with 44.4% (n=20) having excess body weight. The ro was measured based on amh, with an average value of 2.32 (±1.59) ng/ml and rfa, with an average of 19.80 (±14.13) antral follicles. A statistically significant association was found between low adherence to dm and lower an-ti-müllerian hormone (amh; p=0.025) levels. In addition, an association was found between low consumption of vegetables (p=0.044), excessive consumption of red meat (p=0.027) and carbonated beverages (p=0.015) with insufficient amh levels, indicative of low or. Low fruit consumption was also found to be associated with low oestradiol levels (p=0.045). Statistically significant associations were also found reflecting the influence of nutritional status on or.conclusions: one of the main factors conditioning the success of art (assisted reproductive technology) is the woman’s or. The most widely used parameter to assess or is amh. Lifestyle and diet are modifiable factors that can influence or...(AU)

Atención de las personas que viven con VIH en el Sistema de Salud Colombiano: perspectivas de pacientes, cuidadores y personal de salud / Caring for people living with HIV in the Colombian Health System: patients, caregivers and health workers perspectives

Fundamentos: las políticas y programas de atención en salud a las personas que viven con vih han obedecido a las políticas económicas vigentes, basadas en el modelo de desarrollo neoliberal y que configuran el actual sistema de salud. El objetivo de este trabajo fue analizar la influencia del sistema de salud colombiano en la atención de las personas que vivían con vih afiliadas a las entidades administradoras de planes de beneficio del régimen subsidiado, atendidos en neiva (colombia). Métodos: se realizó un estudio cualitativo, enmarcado en el análisis crítico del discurso. Participaron diecinueve personas entre pacientes con vih, cuidadores no formales y personal de salud, captados de dos instituciones prestadoras de servicios de salud de la ciudad de neiva, a quienes se les aplicó entrevistas en profundidad. Los datos fueron codificados, categorizados y organizados en excel para su análisis.resultados: la relación interpersonal y el funcionamiento del sistema de salud fueron dos fenómenos que interfirieron en la atención de las personas con vih, en cuanto a que favoreció o impuso barreras a las prácticas. Se encontraron fallos en el proceso informativo/educativo desde el momento del diagnóstico, estigma y discriminación, profundizado en las instituciones de salud no especializadas en vih, así como múltiples barreras de acceso a los servicios de salud. El 55,5% de los pacientes expresó haber sido discriminados por el personal de salud en algún momento desde su diagnóstico. El 100% de pacientes entrevistados identificó barre-ras de diferente tipo para los servicios de salud, contextualizados en trato indebido, inoportunidad en la atención y abuso del poder; solo el 22,2% recurrió a la interposición de quejas, derechos de petición o tutelas para reclamar su derecho a la salud.conclusiones: la praxis de atención se realiza al margen de la situación de contexto de los pacientes, olvidando que son precisamente los ubicados en un nivel socioeconómico más bajo, quienes tienen mayor vulnerabilidad estructural relacionada con la pobreza, por lo que la falta de atención de salud exacerba las inequidades sanitarias.(AU)

Background: health policies and programs for people living with hiv have been subordinated to current economic policies based on the neoliberal development model that shapes the current healthcare system. The study’s objective was to analyze the influence of the colombian health system on the care of people who lived with hiv enrolled in the subsidized regime through benefit plan administrating entities and treated in neiva (colombia).methods: a qualitative study framed within the framework of the critical discourse analysis was conducted. Nineteen people parti-cipated, including hiv patients, non-formal caregivers, and health workers. The participants were recruited from two health service provi-ders institutions in the city of neiva. In-depth interviews were conducted. Data were coded, categorized and organized in excel for analysis.results: the interpersonal relationship and the health system functioning were two phenomena that interfered with caring for people with hiv by favoring or imposing barriers to practices. Failures were found in the informative-educational process from the moment of diagnosis, stigmatization, and discrimination, particularly in non-hiv-specialized health institutions, and multiple barriers to access to health services. 55.5% of the patients expressed having been discriminated against by health personnel at some point since their diagnosis. 100% of the patients interviewed identified different types of barriers to health services, contextualized in im-proper treatment, untimely care and abuse of power; only 22.2% resorted to the filing of complaints, petition rights or guardianships to claim their right to health.conclusions: health care praxis is carried out regardless of patients’ situation, forgetting that those from a lower socioecono-mic level have greater structural vulnerability related to poverty. The lack of healthcare exacerbates health inequalities.(AU)

Factores asociados a la adherencia a la hemodiálisis y al tratamiento farmacológico en Perú / Factors associated with adherence to hemodialysis and pharmacologic treatment in Peru

Introduction: Inadequate adherence to pharmacological treatment and hemodialysis sessions leads to complications for patients with chronic kidney disease. Objective: To analyze the factors associated with adherence to hemodialysis and pharmacological treatment. Material and Method: This non-experimental, cross-sectional, correlational, and observational study was conducted following approval from the Ethics Committee. The population consisted of 90 patients, from which a sample of 71 was obtained. Information was collected through a questionnaire consisting of the Batalla and MMAS-8 tests. Statistical analysis was performed using Microsoft Excel 2016 and the Statistical Package for the Social Sciences 25. Resultados: 49.30% of patients showed adherence to hemodialysis sessions. However, 94.37% displayed a lack of adherence to pharmacological treatment. Factors associated with adherence to the sessions included age, knowledge about the disease, duration of hemodialysis, number of comorbidities, and number of medications. Factors associated with adherence to pharmacological treatment were knowledge about chronic kidney disease and the number of comorbidities.Conclusions: There is a higher probability of attending hemodialysis sessions when the patient is older, knows about the disease, and has been undergoing dialysis treatment for more than five years. There is a higher likelihood of low pharmaco-logical adherence when the patient has three or more comorbidities. Implementing educational intervention programs is recommended, along with considering strategies such as booklets or mobile phone alarms for medication intake and attendance at hemodialysis. (AU)

Introducción: La inadecuada adherencia al tratamiento farmacológico y las sesiones de hemodiálisis conllevan complicaciones para el paciente con enfermedad renal crónica. Objetivo: Analizar los factores asociados a la adherencia a la hemodiálisis y al tratamiento farmacológico. Material y Método: Diseño no experimental, transversal, correlacional y observacional, tras aprobación del Comité Ético. Población conformada por 90 pacientes, de la cual se obtuvo una muestra de 71. La información se recolectó mediante un cuestionario conformado por el test de Batalla y test MMAS-8. Se realizo análisis estadístico con Microsoft Excel 2016 y Statistical Package for the Social Sciences 25. Resultados: El 49,30% de los pacientes presentaron adherencia a las sesiones de hemodiálisis, sin embargo, el 94,37% tuvo falta de adherencia al tratamiento farmacológico. Los factores asociados con la adherencia a las sesiones fueron la edad, el conocimiento sobre la enfermedad, el tiempo de hemodiálisis, el número de comorbilidades y el número de fármacos. Los factores asociados con la adherencia al tratamiento farmacológico fueron el conocimiento sobre la enfermedad renal crónica, y el número de comorbilidades. Conclusiones: Existe mayor probabilidad de cumplir con las sesiones de hemodiálisis cuando el paciente es adulto mayor, tiene conocimiento sobre la enfermedad, y lleva más de cinco años en tratamiento dialítico. Existe mayor probabilidad de tener baja adherencia farmacológica cuando el paciente presenta de 3 a más comorbilidades. Se recomienda la implementación de programas educativos de intervención y considerar estrategias como cartillas o alarmas en celulares para el consumo de fármacos y la asistencia a la hemodiálisis. (AU)

Eficacia del ejercicio de alta intensidad en personas con dolor lumbar crónico: una revisión sistemática / Efficacy of high-intensity exercise in people with chronic low back pain: A systematic review

El dolor lumbar crónico causa discapacidad e impacto socioeconómico. El ejercicio de alta intensidad muestra resultados positivos en otras enfermedades, pero no existe evidencia sobre esta patología. Se pretende determinar su eficacia en la calidad de vida relacionada con la salud, la discapacidad, la intensidad del dolor y la adherencia al tratamiento en personas con dolor lumbar crónico. Se realiza una revisión bibliográfica en Pubmed, PEDro y Scopus, incluyendo ensayos clínicos aleatorizados, guías de práctica clínica y revisiones sistemáticas en español, inglés o portugués (2012-2022). Además, se hace una búsqueda en bola de nieve. Se incorporan ocho ensayos clínicos aleatorizados (n=379). Se analizan diferentes modalidades de ejercicio de alta intensidad, que parecen mejorar la calidad de vida relacionada con la salud y reducir la discapacidad y la intensidad del dolor. Estos datos se deben tomar con cautela dada la poca cantidad de estudios y el riesgo de sesgo que presentan.(AU)

Chronic low back pain causes disability and socioeconomic impact. High-intensity exercise shows positive results in other diseases, but there is no evidence on this pathology. The aim is to determine its efficacy on health-related quality of life, disability, pain intensity and adherence to treatment in people with chronic low back pain. A literature review is conducted in Pubmed, PEDro and Scopus, including randomized clinical trials, clinical practice guidelines and systematic reviews in Spanish, English or Portuguese (2012-2022). In addition, a snowball search is performed. Eight randomized clinical trials (n=379) are incorporated. Different high-intensity exercise modalities are analyzed, which seem to improve health-related quality of life and reduce disability and pain intensity. These data should be taken with caution given the small number of studies and the risk of bias presented.(AU)

Antiretroviral adherence and treatment outcomes among patients living with HIV at an Indonesian HIV clinic: a cross-sectional study / Cumplimiento de los antirretrovirales y resultados del tratamiento entre pacientes que viven con el VIH en una clínica de VIH de Indonesia: un estudio transversal

Objective: This study assessed antiretroviral adherence and treatment outcomes among outpatients with human immunodeficiency virus (HIV). Methods: A cross-sectional study was performed on patients with HIV over 18 years old receiving antiretroviral therapy for at least six months at an Indonesian clinic, from January to March 2021. The previously validated self-reported adherence questionnaire was used to recall antiretroviral use. Viral load and CD4 were indicators of treatment outcomes. Binary logistic regression was used to explore factors associated with nonadherence and poor treatment outcomes. Results: Ninety-five patients were included in the study (male 70.5%, median [interquartile range, IQR] age 35 [29–42] years, and median [IQR] treatment duration 29 [15–49] months). Adherence greater than 95% was observed in 89.5%, 88.4%, 95.8% of the patients in the past week, month, and three months, respectively. Patients with secondary education or lower were associated with low adherence (adjusted odds ratio, aOR: 7.73, 95%CI: 1.12– 53.19). Viral suppression and improved CD4 were observed in 83.2% and 68.4% of the patients, respectively. Taking non-nucleoside reverse transcriptase inhibitors (NNRTIs)-based regimen was associated with viral suppression (aOR: 0.01, 95%CI: 0.00–0.14) as well as high CD4 count (aOR: 0.16, 95%CI: 0.03– 0.83). Being diagnosed with stage 4 of HIV (aOR: 72.38, 95%CI: 3.11–1687.28) and having adherence of 95% or lower (aOR: 68.84, 95%CI: 4.86–974.89) were associated with non-suppressed viral load, and having HIV stage 3 (aOR: 7.81, 95%CI: 1.26–48.40) or 4 (aOR: 26.15, 95%CI: 3.42–200.10) at diagnosis was associated with low CD4. Conclusion: Rates of self-reported adherence and treatment outcomes were high. Secondary education or lower was a predictor of low adherence. Using NNRTIs-based therapy was associated with good treatment outcomes; meanwhile, stage 3 or 4 of HIV at diagnosis and low adherence were predictors of poor outcomes. Therefore, strategies to improve adherence and treatment outcomes are warranted.(AU)

Factors affecting the outcomes in stable chronic obstructive pulmonary disease patients at an Army Central Hospital / Factores que afectan los resultados en pacientes estables con enfermedad pulmonar obstructiva crónica en un Hospital Central del Ejército

Background: Of the four Asian countries, Indonesian COPD patients have the worst clinical features, which puts them at a high risk for treatment failure. There are a number of variables and patient traits that influence clinical results as a predictor of therapy outcomes. Objective: to identify the contributing components and how much they influence COPD patients’ therapy results. Methods: This cross-sectional descriptive-observational study at a tertiary army hospital involved 74 patients. A questionnaire and medical records were utilized to obtain sociodemographic characteristics and clinical data. Correlation and logistic regression analysis were conducted to identify significant factors. Results: The results showed that tumor/cancer comorbidities affected the worsening of CAT values (OR=10.89, 95%CI=1.01-117.23, p=0.049), use of ICS/LABA drugs affected the improvement of mMRC values (OR= 0.26, 95%CI=0.08-0.84, p=0.024), history of TBC disease affected the increase in exacerbation severity (OR=7.25, 95%CI=1.05-50.23, p=0.045), age from smoking >20 years affected the reduction in exacerbation severity (OR=0.03, 95%CI=0.002-0.61, p=0.022). History of alcohol use (OR=7.26 and 167.56, p=0.014 and 0.004) and comorbid pneumonia (OR=28.14 and 44.25, p=0.035 and 0.014) contributed to an increase in the frequency of exacerbations and hospitalization per year. Medium economic status affects the decrease in hospitalizations per year (OR=0.06, 95%CI=0.00-0.91, p=0.043) while the diagnosis of severe COPD and history of alcohol affected the decrease in COPD severity (ABCD) (OR=0.12 and 0.24, p=0.039 and 0.009). Conclusion: comorbidities, disease history, history of alcohol use, COPD status and the use of COPD medications contributed to variations therapeutic outcomes COPD patients. Therefore, it must be taken into account when making clinical decisions.(AU)

Personality dimensions and treatment adherence among glaucoma patients: the role of self-transcendence.

BACKGROUND: Cloninger's psychobiosocial model of personality proposes that consistent patterns of health behavior are determined by the complex interaction of different neurobiological processes of the patient's temperament and character dimensions. Poor medication adherence is a pervasive problem among glaucoma patients and can lead to increased morbidity and disability. The objective of the present study was to investigate the association between Cloninger's personality dimensions and medication adherence among glaucoma patients. METHODS: The cross-sectional study was conducted among 113 primary open-angle glaucoma (POAG) patients. The treatment adherence was assessed through a valid and reliable self-administered questionnaire, the Culig Adherence Scale (CAS). Personality dimensions were evaluated using the abbreviated version of the Temperament and Character Inventory-Revised (TCI-140). Statistical analyses were performed using TIBCO Statistica 14.0.1. The study protocol was registered in the DRKS - German Clinical Trials Register; (DRKS-ID: DRKS00022081). RESULTS: According to CAS, only 39.8% of patients were adherent to glaucoma treatment. Adherence was significantly negatively related only to the character dimension of Self-Transcendence (p < 0.05). No other TCI-140 dimension was significantly associated with medication adherence (p > 0.05). CONCLUSIONS: The results suggest that POAG patients with higher scores on the Self-Transcendent personality dimension are more likely to experience difficulties adhering to medication regimen. The study highlights the importance of a holistic approach to glaucoma treatment, which takes into account not only the biological aspects of disease but also the psychosocial factors that influence patient behavior. Healthcare providers may need to consider glaucoma patients' personality dimensions, beliefs and values when developing treatment plans and strategies to improve medication adherence.

HIV-Related Stigma and Treatment Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Meth in the Metropolitan Area of Mexico City.

Internationally, HIV-related stigma and crystal methamphetamine (meth) use have been described as barriers to treatment adherence among gay, bisexual, and other men who have sex with men (gbMSM). Crystal meth use has been increasing among gbMSM in the Metropolitan Area of Mexico City (MAMC). Therefore, this study aimed to determine the association between HIV-related stigma and HIV treatment adherence among gbMSM who use crystal meth in the MAMC. This study was undertaken as part of an exploratory study of crystal meth use in the MAMC. The data were collected from September to December 2021 through an encrypted online survey. Participants (n = 89) were gbMSM adults living with HIV who reported crystal meth use in the past month that were recruited through an online snowball sampling. The online survey included questions about HIV treatment adherence, sexual behaviors, the Alcohol, Smoking, and Substance Involved Screening Test, and the HIV-Related Stigma Mechanisms Scale. Logistic regression analyses assessed the association between HIV-related stigma and HIV treatment adherence. The multivariate logistic regression model showed that, controlling for health insurance [adjusted odds ratio (AOR) = 0.13; 95% confidence intervals (CI)  = 0.02-0.59] and educational level (AOR = 0.16; 95% CI = 0.02-0.88), non-adherence to HIV treatment was independently associated with higher HIV-related stigma (AOR = 1.06; 95% CI = 1.01-1.12). Public health policies must include HIV-related stigma and substance use in treating gbMSM with HIV.

The impact of hope levels on treatment adherence in psychiatric patients.

PURPOSE: In this study, aimed to determine the status of hope and treatment adherence in psychiatric patients and the relationship between the two. MATERIAL AND METHOD: The sample of the study consisted of participants (n = 103) in a university hospital psychiatric clinic. Research data were collected using personal information form, Morisky treatment adherence scale and Herth Hope Index (HHI). Statistical analysis of the data was carried out with SPSS 22.0 program using descriptive tests, student t-test, one-way variance analysis, chi-square test and Spearman correlation analysis. RESULTS: The average score of the patients' hope scale is 34.23 ± 9.59 and is above the intermediate level. 43.7 % of patients have low adherence with treatment. It was found that as patients' hope scores increased (r = -0.417) non-adherence with treatment decreased; as annual hospitalization increased non-adherence increased (r = 0.274); as the duration of disease increased score of hope (r = -0.271), non-adherence with therapy (r = 0.353) and annual hospitalization increased (r = 0.211) (p < .05). Among the patients who took part in the study, 36.9 % were diagnosed with bipolar disorder, 33.0 % with schizophrenia and other psychotic disorders, 20.4 % with depression. Patients with bipolar disorder had higher treatment non-adherence scores. It was determined that 29.1 % of the patients stopped taking medication thinking they had recovered and 28.2 % did not adhere to the treatment due to drug side effects. CONCLUSION: The findings underscore the crucial role of hope in influencing treatment adherence among psychiatric patients. Clinicians should consider strategies to bolster hope as a potential avenue for improving adherence rates.

Evaluación de una intervención grupal basada en mindfulness en pacientes con ansiedad y depresión atendidos en un centro comunitario de salud mental: estudio cuasi experimental / Evaluation of a group intervention based on Mindfulness in patients with anxiety and depression cared for in mental health community center: a quasy-experimental study

Objetivo: Evaluar la efectividad de una intervención grupal basada en mindfulness en pacientes con ansiedad y depresión atendidos en un centro de salud mental comunitario. Secundariamente, valorar la calidad de vida y la adherencia a la intervención. Método: Estudio cuasi experimental con evaluaciones pre y postintervención llevado a cabo entre marzo de 2015 y diciembre de 2019 en personas mayores de 18 años atendidas en el Centro de Salud Mental de Adultos (CSMA) de Les Corts, Barcelona. Como criterios de inclusión se tomaron en cuenta: 1) sintomatología de ansiedad (Escala de Ansiedad de Hamilton [HARS] > 10 puntos) y 2) firma de consentimiento informado. Las variables recogidas fueron 1) ansiedad, 2) depresión (Inventario de Depresión de Beck [BDI]), 3) calidad de vida (EuroQoL [EQ-5D]) y 4) adherencia a la intervención. La intervención fue de nueve sesiones semanales de 75 min y fue realizada por dos enfermeras. Cada grupo estaba formado por 10-15 pacientes. Resultados: Un total de 128 usuarios fueron incluidos, de los cuales 103 eran mujeres con una edad media de 52,23 (desviación estándar [DE] 12,78). Al comparar medidas pre y post, se observaron mejoras en relación con la sintomatología ansiosa, depresiva y la calidad de vida general (p<0,001) y sus dimensiones de ansiedad-depresión (EQ-5D) (p=0,003). La media de sesiones asistidas fue de 6,17 (DE 2,31) y estaban correlacionadas de forma estadísticamente significativa y positiva con una mejora de la sintomatología ansiosa (p<0,001) y depresiva (p=0,021). No se observaron diferencias entre grupos de edad. Conclusiones: La intervención grupal basada en mindfulness mejora la sintomatología ansiosa y depresiva, así como la calidad de vida. Esto se asocia con una mayor adherencia a la intervención.(AU)

Objective: To evaluate the effectiveness of a group intervention based on Mindfulness in patients with anxiety and depression treated in a community mental health center. Secondarily, to evaluate quality of life and adherence to the intervention. Methods: Quasi-experimental study with evaluations pre-post intervention in people over 18 years of age treated at the Les Corts Adult Mental Health Center (AMHC), Barcelona, between March 2015 and December 2019. Inclusion criteria: 1) anxiety symptoms (Hamilton Anxiety Rating Scale > 10 points); 2) sign informed consent. Variables collected: 1) anxiety; 2) depression (Beck Depression Inventory); 3) quality of life (EuroQoL [EQ-5D]) and 4) adherence to the intervention. The intervention (9 weekly sessions; 75 minutes) was carried out by two nurses. Each group consisted of 10-15 patients. Results: 128 patients were included, of which 103 were women with a mean age of 52.23 years (SD 12.78). Comparisons pre and post measures, its showed improvements in relation to anxiety, depressive symptoms and general quality of life (p<0.001) and in its dimensions of anxiety-depression (EQ-5D) (p=0.003). The mean number of sessions attended was 6.17 (SD 2.31), and they were statistically significant and positively correlated with an improvement in anxiety (p<0.001) and depressive symptoms (p=0.021). There were no differences between age groups. Conclusion: The intervention group based on Mindfulness improves anxiety and depressive symptoms, as well as the quality of life. This improvement in the symptomatology is associated with a greater adherence to the intervention.(AU)

Factores asociados al rendimiento académico de los adolescentes de La rioja (España): hábitos de vida, indicadores de salud y factores sociodemográficos / Factors associated with academic performance in adolescents from La Rioja (Spain): lifestyle habits, health indicators, and sociodemographic factors

Introducción: el rendimiento académico está influenciado por numerosos factores, algunos de índole personal y otros contextuales, que, además, poseen una estrecha relación con la salud de los estudiantes. Por ello, el objetivo del estudio fue analizar la relación e influencia de los hábitos de vida, diversos indicadores de salud física y psicosocial, y variables sociodemográficas sobre dicho rendimiento. Método: el estudio se llevó a cabo sobre una muestra de 761 estudiantes (14,51 ± 1,63 años) de 25 centros educativos de una región del norte de España. Se valoró el rendimiento académico, así como la calidad de vida relacionada con la salud, la autoestima, la adherencia a la dieta mediterránea, las horas de sueño nocturno, el nivel de actividad física, el entorno para la práctica de dicha actividad física, la participación en actividades deportivas extraescolares, el consumo máximo de oxígeno, el índice de masa corporal y diversos factores sociodemográficos. Resultados: ser chico, tener origen migrante y poseer un nivel socioeconómico bajo/medio, una capacidad cardiorrespiratoria en zona de riesgo, una menor adherencia a la dieta mediterránea e índices más bajos de calidad de vida relacionada con la salud resultaron asociarse a un menor rendimiento académico, llegando a explicar hasta el 14 % de su varianza según el análisis de regresión. Igualmente, los adolescentes con mayor autoestima, menor índice de masa corporal, las chicas, aquellos que residían en un entorno favorable para la práctica física, los que realizaban actividad física extraescolar y los que presentaban mayor número de horas de sueño nocturno, mostraron mayores índices de rendimiento académico. Conclusiones: las intervenciones dirigidas a combatir el fracaso escolar deberían tener en cuenta los factores asociados citados, haciendo especial hincapié en los grupos más vulnerables como los chicos, aquellos con menor nivel socioeconómico y los que siguen unos hábitos de vida no saludables.(AU)

Introduction: academic performance is influenced by numerous factors, some personal and others contextual in nature, which also have a closerelationship with the health of students. Therefore, the aim of this study was to analyze the relationship and influence of lifestyle habits, variousphysical and psychosocial health indicators, and sociodemographic variables on academic performance.Method: the study was carried out on a sample of 761 students (14.51 ± 1.63 years old) from 25 educational centers in a region of northernSpain. Academic performance was assessed, as well as health-related quality of life, self-esteem, adherence to the Mediterranean diet, hoursof nocturnal sleep, level of physical activity, environment for the practice of physical activity, participation in extra-curricular sports activities,maximum oxygen consumption, body mass index, and various sociodemographic factors.Results: being male, having immigrant origins, as well as having a low/medium socioeconomic level, a cardiorespiratory capacity in the risk zone,lower adherence to the Mediterranean diet, and lower health-related quality of life indices were associated with lower academic performance,explaining up to 14 % of its variance according to the regression analysis. Likewise, adolescents with higher self-esteem, lower body mass index,females, those who lived in a favorable environment for physical activity practice, engaged in extra-curricular physical activity, and had a highernumber of hours of nocturnal sleep showed higher levels of academic performance.Conclusions: interventions aimed at combating academic failure should take into account the aforementioned associated factors, with specialemphasis on the most vulnerable groups such as males, those with lower socioeconomic status, and those who follow unhealthy lifestyle habits.(AU)

Adhesión a la dieta mediterránea y conducta alimentaria en escolares españoles / Adherence to the Mediterranean diet and eating behaviour in Spanish schoolchildren

Introducción: las conductas alimentarias pueden modular o influir en la calidad de la dieta y el grado de adherencia a la dieta mediterráneade niños y adolescentes.Objetivos: investigar la asociación entre la calidad de la dieta y el comportamiento alimentario en un grupo de escolares españoles.Métodos: se trata de un estudio transversal descriptivo en una muestra de 283 escolares españoles de seis a 16 años. Cada sujeto fue evaluadomediante el cuestionario KIDMED de adherencia a la dieta mediterránea y el cuestionario Children’s Eating Behaviour Questionnaire (CEBQ) paraevaluar el comportamiento alimentario.Resultados: un 12,80 % de la muestra presentó baja adherencia a la dieta mediterránea; un 59,80 %, adherencia mejorable; y un 27,40 %,adherencia alta. Al relacionar las conductas alimentarias con la calidad dietética, los escolares con mayor disfrute por los alimentos y menosexigencia con la comida presentan el doble de adherencia a la dieta mediterránea, por un consumo de casi el doble de vegetales, frutos secoso pescado, así como menor ingesta de procesados de baja calidad (golosinas y dulces). La respuesta a la saciedad y la velocidad de ingestatambién tuvieron un papel importante en las elecciones alimentarias.Conclusiones: las conductas alimentarias pueden tener un importante papel en la calidad de la dieta de los escolares, destacando el disfrute y laaceptación o rechazo por los alimentos. Dada la naturaleza bidireccional de los efectos entre las conductas alimentarias y la calidad de la dieta, elanálisis conjunto puede ser la base de futuras investigaciones con el objetivo de un mejor abordaje nutricional desde las edades más tempranas.(AU)

Introduction: eating behaviors may modulate or influence diet quality and the degree of adherence to the Mediterranean diet in children andadolescents.Aims: to investigate the association between diet quality and eating behavior in a group of Spanish schoolchildren.Methods: descriptive cross-sectional study of 283 Spain schoolchildren aged six to 16. Each subject was assessed using the KIDMED question-naire for adherence to the Mediterranean diet and the Children’s Eating Behaviour Questionnaire (CEBQ) questionnaire to assess eating behavior.Results: of the sample, 12.80 % had low adherence to the Mediterranean diet, 59.80 % had poor adherence, 59.80 % could be improved, and27.40 % had high adherence. When relating eating behavior to dietary quality, it was found that, generally, schoolchildren with greater enjoymentof food and less demand for food have double the adherence to the Mediterranean diet due to almost twice the consumption of vegetables,nuts, and fish, and a lower intake of low-quality processed foods (sweets). The response to satiety and the speed of ingestion also played animportant role in food choices.Conclusions: eating behaviors may play an essential role in the quality of school children’s diets highlighting the enjoyment and acceptance orrejection of food. Given the bidirectional nature of the effects between eating behaviors and diet quality, the joint analysis may be the basis forfuture research with the aim of a better nutritional approach from the earliest ages.(AU)