Medication adherence

Therapeutic drug monitoring Practice guideline development and adherence Medication error prevention and tracking Quality improvement Pharmacoeconomic assessment... 

Several other factors that are not included in the MAI also should be assessed (1) suboptimal medication choice (based on effectiveness, safety, cost, and effects on HRQOL), (2) allergy (especially for new prescriptions), (3) undertreatment, and (4) drug interactions with food or laboratory tests. Some additional factors to consider during drug regimen review include adherence, medication storage problems, laboratory monitoring, therapeutic end points, and ADRs. 

Adhere to company medic policies (e.g., annual physicals)... 

Another technological area that relies on particle adhesion is pharmacology. Consider, for example, an aerosol-dispensed medication. Here, the active ingredient relies on its adhering to inert carrier particles to be dispensed. However, it is crucial that the carrier particles do not adhere to the container walls, or much of the medication would never reach the patient. 

No matter what type of respirator is used, it is of the utmost importance that the revised respiratory standard is adhered to. The revised standard stresses training, documentation, written programs, medical surveillance, fit testing, and a variety of other subjects pertinent to respirators. Of particular interest to the authors is the new approach toward action levels, protection factors, and fit testing. Another important change is OSHAs latest approach on voluntary respirator use. With the new standard in effect, those workers previously considered to be voluntarily wearing respirators should be much better protected. 

With all of these pharmacotherapies, concurrent behavioral treatment is critical to retain the patient in treatment and maintain adherence to medication treatment. Contingency management programs in which patients receive vouchers that can be used to purchase pro-social goods and services are the most common reinforcer approaches used to initiate and maintain stimulant-free urine test results (Anker and Crowley 1982 Boudin 1972 Higgins et al. 1991, 1993, 1994). The major problem with these approaches has been maintaining abstinence after the reinforcers are withdrawn completely and devel-... 

Studies have shown that CM can be used to directly reinforce adherence to medication treatments as well (Petty 2000). Liebson et al (1978) found that methadone-maintained alcohol-dependent patients reduced alcohol use when methadone treatment was contingent on disulfiram consumption. To date, one of the most common applications of CM techniques to pharmacotherapy has been the provision of vouchers or cash contingent upon naltrexone consumption in recently detoxified opioid-dependent patients (Carroll et al. 2001, 2002 Preston et al. 1999). These studies have generally reported significant increases in retention and reductions in opioid use among patients receiving the CM treatment, relative to other therapies. 

Carroll et al. (2004) conducted another study examining psychotherapy and disulfiram treatment for cocaine dependence. In this randomi2ed, doubleblind, placebo-controlled study, patients (iV=121) were assigned to one of four conditions 1) disulfiram plus CBT 2) disulfiram plus interpersonal therapy (IPT), which addressed adherence to a medical model of psychiatric problems, interpersonal functioning, and supportive therapeutic exploration 3) placebo plus CBT or 4) placebo plus IPT. The patients who received disulfiram reduced their cocaine use, relative to those who received placebo, and the patients who received CBT reduced their cocaine use, relative to those who received IPT. Cocaine abstinence among the patients who received CBT plus placebo was not statistically different from that of the patients who re-... 

Many studies have examined the efficacy of a variety of psychosocial treatments for alcohol, cocaine, and opioid use disorders, alone and in conjunction with pharmacotherapy. However, only a handful of studies have explored how these two treatment approaches may interact. More research is needed to further explore the ways in which psychosocial interventions may be used in conjunction with pharmacotherapy to optimize outcomes for both treatments. Providing encouragement for abstinence, greater treatment retention, medication adherence, and coping with medication side effects are some potential applications of psychosocial therapies. 

In some pharmacotherapy studies, psychotherapy exposure has been minimized, on the basis of concern that psychotherapy may produce a ceiling effect on improvement in drug or alcohol use, making medication effects difficult to detect. However, a recent meta-analysis revealed that psychosocial interventions, in fact, may enhance pharmacotherapeutic effects (Hopkins et al. 2002). In this review we have also noted instances where psychosocial and medication treatments have had beneficial additive effects. Minimization of psychotherapy in pharmacotherapy trials may be counterproductive, because psychosocial therapies that encourage the patient to remain engaged in treatment may positively affect patients adherence to the medication regimen, a factor that has an effect on alcohol treatment outcomes (Chick et al. 2000 Volpicelli et al. 1997). 

Concerning adherent cells there are few studies in the literature. Some of them deal with the influence of stirrer speed on microcarrier cultures. Most studies using defined forces are from medical research. These studies, as well as those with production cells, use different types of exposure systems based on the parallel plate theory. They investigate the influence of stress on cell morphology and viability which is most important for arteriosclerosis research. 

Adverse events need to be coded consistently with respect to letter case. Problems can occur when there is discordant coding using all capital letters, all lower-case letters, or combinations thereof, as computer software will interpret these capitalization variations as different events. Letter case sensitivity can be important when two or more words are used to describe an adverse event. For example, some databases utilizing the Medical Dictionary for Regulatory Activities (MedDRA) coding dictionary employ a coding system in which only the first letter of the first word of an adverse event is capitalized (e.g., Atrioventricular block complete ). Failing to adhere to uniform letter case conventions across the data can result in severe errors in data analysis. 

Crucial factors affecting overall cost are the responsiveness to medication (for example, less than 70% of patients are lithium responders ), adherence to recommended treatment, and adverse events resulting from medication. A particular hazard of lithium treatment is the risk of rapid re-emergence of mania, which occurs in up to 50% of patients if the dmg is abruptly discontinued (see Cookson, 1997). Disappointingly, it has not been found that the introduction of widespread treatment with lithium has been associated with a reduction in the number of patients admitted and discharged from hospital with a diagnosis of mania. In order to achieve the best result with the available... 

Polyelectrolytes form the basis of those modern cements which are distinguished by their ability to adhere to reactive surfaces. At present the main use of such cements lies in the medical field, principally in dental surgery. They adhere permanently to biological surfaces where they have to withstand adverse conditions of wetness, chemical attack, the stress of biological activity, and chemical and biological changes within the substrate. Nevertheless, adhesive bonds are maintained. 

Biofilms adhere to surfaces, hence in nearly all systems of interest, whether a medical device or geological media, transport of mass from bulk fluid to the biofilm-fluid interface is impacted by the velocity field [24, 25]. Coupling of the velocity field to mass transport is a fundamental aspect of mass conservation [2]. The concentration of a species c(r,t) satisfies the advection diffusion equation... 

The clinician must identify potential reversible causes of heart failure exacerbations including prescription and nonprescription drug therapies, dietary indiscretions, and medication non-adherence. 

HF medications deserves special attention, as it is the most common cause of acute decompensation and can be prevented. As such, an accurate history regarding diet, food choices, and the patient s knowledge regarding sodium and fluid intake (including alcohol) is valuable in assessing dietary indiscretion. Nonadherence with medical recommendations such as laboratory and other appointment follow-up can also be indicative of non-adherence with diet or medications. 

Heart transplantation represents the final option for refractory, end-stage HF patients who have exhausted medical and device therapies. Heart transplantation is not a cure, but should be considered a trade between a life-threatening syndrome and the risks associated with the operation and long-term immunosuppression. Assessment of appropriate candidates includes comorbid illnesses, psychosocial behavior, available financial and social support, and patient willingness to adhere to lifelong therapy and close medical follow-up.1 Overall, the transplant recipient s quality of life may be improved, but not all patients receive this benefit. Posttransplant survival continues to improve due to advances in immunosuppression, treatment and prevention of infection, and optimal management of patient comorbidities. 

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