Chapter
Evidence-Based Directions for Polypharmacy Revision: The Experience Gained by the Campania Reference Site in the Framework of the EIP-AHA Action Group A1 and of the FRIENDD Pilot Study
Why Polypharmacy is so Important for Poor Adherence in Older Adults?
The Current Approach to Polypharmacy in Italy and the Rationale of the Friendd Pilot
Study Design of the Friendd Pilot
Preliminary Results of the Friendd Pilot
Health Governance Initiatives for Polypharmacy Optimization That Have Been Implemented at the Federico II University Hospital
The Contribution of Technologies to the Adherence to Medication by Older People: A Systematic Approach
Inclusion and Exclusion Criteria
Data Extraction and Analysis
Implications for Further Research
Qualitative Studies on Medication Adherence: What Do They Add to Knowledge Gained by Quantitative Methods?
1. The Present and the Future: Towards Multiple Chronic Diseases and Polytherapy
3. Factors Influencing Adherence Behaviour
4. Patient-Related Factors
4.1. Beliefs and Emotions
4.1.1. Patient’s View About Medications
4.1.2. Disease and Medication Hierarchy
4.2. Capabilities, Personality and Behavioral Traits
4.4. The Need to Be Informed
5. Treatment-Related Factors
5.1. Medicines and Their Effect
5.2. Cost and Accessibility
5.3. Characteristics of the Disease
6. Patient-Health Care Professional Relationship
6.1. Relationship Quality
6.2. Provider’s Role and the Importance of the Communication
7.1. Health Literacy and Sources of Information
7.3. Family and Social Support
8.1. A Useful Model of Adherence
8.2. What Qualitative Research Adds to Quantitative Knowledge on Adherence?
8.3. Clinical Implications
Empowering Senior Citizens and Professionals to Improve Adherence to Care Plans
Empowerment and Activation
Productive Interactions between Activated Citizens and Proactive and Prepared Practice Teams
The Action Group A1 of the EIP on AHA
Enhancing Adherence through Education
2. Education can be a Powerful way to Enhance Adherence
2.1. Efficacy of Communication between Health Professionals and Patients
2.1.1. Verbal Communication
2.1.2. Written Communication
2.1.3. Internet–Based Communication
2.1.4. Individuals vs. Group–Based Interventions
3. Improved Health Literacy as an Invaluable Goal of Health Education
4. Defining New Roles in Education Interventions for Health Care Professionals
Enhancing Patient Adherence through Integrated Educational Programs Based on Psychological Techniques and Practices
Psycho-Educational Interventions to Enhance Adherence: Theory and Model
Analysis of Specific Psychological Interventions to Enhance Adherence
CBT for Adherence and Depression (CBT-AD)
Clinical Issues to Enhance Older Patients Adherence
Medication Adherence in the Aging Population: The Role of Pharmacokinetics and Pharmacodyamics
What Are Pharmacokinetics and Pharmacodynamics?
Pharmacokinetics in the Older Person
Pharmacokinetics in the Older Person: Absorption
Pharmacokinetics in the Older Person: Metabolism
Pharmacokinetics in the Older Person: Distribution
Pharmacokinetics in the Older Person: Drug Elimination
Pharmacodynamics (PD) in the Older Person
PK/PD in the Older Person: Role of Therapeutic Drug Monitoring in Enhancing Adherence
Role of PK/PD in Enhancing Adherence Due to Improved Drug Formulations
Discussion and Conclusion
Behavioral Interventions in Adherence: The Concept of Nudge
The Challenge of Patient Adherence
Improving Treatment Adherence: Classical Approaches
Alternative Approaches to Improve Adherence
The Dual-process Theory of Thought
Nudging Medication Adherence
Nudging Adherence with Reminders, Incentives, and Monitoring/Feedback Systems
Nudging Adherence through Defaults
Measuring Medication Adherence in Health-Related Databases
1.1. Computerized Health-Related Databases
1.1.1. Administrative/Claims Databases
1.1.2. Medical Record or Primary Care Databases
1.1.5. Specific Applications
1.2. Pharmacy Records as Tool to Measure Medication Adherence
1.2.1. Definition of Medication Adherence
1.2.2. Measurement of Medication Adherence
1.2.3. The ATC/DDD Methodology
1.2.4. Prevalence of Medication Non-Adherence
1.2.5. Predictors of Medication Non-Adherence
1.2.6. Effect of Policy Changes on Medication Adherence
1.2.7. Definition and Measurement of Exposure and Outcome
1.2.8. Clinical and Economic Outcomes of Non-Adherence
1.2.9. Advantages and Disadvantages
The Impact of Changes in Pill Appearance on the Adherence to Medication
Definition of Pill Appearance
Implications of Legislation Related to Generics and Pill Appearance
Research into Impact of Pill Appearance
Practical Issues Related to Pill Appearance in a Community Pharmacy
Treatment Adherence in Patients with Rheumatoid Arthritis
Used Methods for Assessing the Adherence
Self-Report from Discussion
Drug Concentration/Metabolites
Prescription Refill from Pharmacies
Parallel of Different Adherence Measures
Condition-Related Factors
Analysis for Adherence on NSAIDs Therapies
Analysis for Adherence on DMARDs Therapies
Biologic Drug Therapy Adherence
Biosimilar Drug Therapy Adherence
Adherence to Medical Plans in End-Stage Kidney Disease Patients Under Dialysis
Non-Adherence to Medical Plans
Missing and Shortening Dialysis Sessions
Dietary and Fluid Restrictions Adherence
Interventions to Promote Adherence
Adherence to Topical Treatment in Psoriasis
Topical Treatment of Psoriasis
Adherence to Topical Treatment in Psoriasis
Strategies to Promote Adherence to Topical Treatment in Psoriasis
Adherence to Medical Plans for Active and Healthy Ageing
( Aging Issues, Health and Financial Alternatives )
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