Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis

AIM To investigate the impact of medication beliefs, illness perceptions and quality of life on medication adherence in people with decompensated cirrhosis.METHODS One hundred adults with decompensated cirrhosis completed a structured questionnaire when they attended for routine outpatient hepatology review. Measures of self-reported medication adherence(Morisky Medication Adherence Scale), beliefs surrounding medications(Beliefs about Medicines Questionnaire), perceptions of illness and medicines(Brief Illness Perception Questionnaire), and quality of life(Chronic Liver Disease Questionnaire) were examined. Clinical data were obtained via patient history and review of medical records. Least absolute shrinkage and selection operator and stepwise backwards regression techniques were used to construct the multivariable logistic regression model. Statistical significance was set at alpha = 0.05.RESULTS Medication adherence was " High " in 42 % o f participants, "Medium" in 37%, and "Low" in 21%. Compared to patients with "High" adherence, those with "Medium" or "Low" adherence were more likely to report difficulty affording their medications(P < 0.001), lower perception of treatment helpfulness(P = 0.003) and stronger medication concerns relative to medication necessity beliefs(P = 0.003). People with "Low" adherence also experienced greater symptom burden and poorer quality of life, including more frequent abdominal pain(P = 0.023), shortness of breath(P = 0.030), and emotional disturbances(P = 0.050). Multivariable analysis identified having stronger medication concerns relative to necessity beliefs(Necessity-Concerns Differential ≤ 5, OR = 3.66, 95%CI: 1.18-11.40) and more frequent shortness of breath(shortness of breath score ≤ 3, OR = 3.87,95%CI: 1.22-12.25) as independent predictors of "Low"adherence.CONCLUSION The association between "Low" adherence and patients having strong concerns or doubting the necessity or helpfulness of their medications should be explored further given the clinical relevance.

The application of the necessity-concerns framework in investigating adherence and beliefs about immunosuppressive medication among Chinese liver transplant recipients

Objective： This study aimed to explore adherence to and beliefs about immunosuppressive medication using the Necessity-Concerns Framework（NCF） in liver transplant recipients.Methods： A cross-sectional study performed in recipients who were at least 3 months post liver transplantation. A convenience sample of 243 recipients was recruited. Self-reported medication adherence was measured by the Basel Assessment of Adherence with Immunosuppressive Medication Scale（BAASIS）. The NCF was operationalized using the Beliefs about Medication Questionnaire（BMQ） to assess the beliefs about necessity and concerns with taking immunosuppressive medication.Results： One-hundred-forty-five liver transplant recipients were non-adherent（59.67%）. Compared to adherers, non-adherers had lower beliefs regarding the necessity of taking immunosuppressive medication and lower scores on the necessity-concerns different from adherers.Conclusions： Non-adherence is common in liver transplant recipients. Non-adherers hold beliefs that are different from adherers. Efforts to increase adherence should be made by targeting medication beliefs.

Attitudes towards prescribing psychiatric medicines: Do the views of psychology and medical students differ?

Concordance has been suggested as a process of the consultation in which prescribing process is based on partnership. The aim of this cross-sectional study was to compare attitudes towards psychiatric medication and concordance in medicine taking between medical and psychology students, as they represent future members of mental health teams. Two hundred and sixteen medical students and 222 psychology students completed the Leeds Attitudes toward Concordance scale (LATCon) and the Beliefs about Medication Questionnaire (BMQ) (both adapted for psychiatric medication). Psychology students saw psychiatric medicines as more harmful and were also most likely to believe that psychiatrists overprescribed these medicines. They also scored higher than medical students on attitudes towards concordance, although this difference remained at the limit of statistical significance.

An Advanced Uncertainty Measure Using Fuzzy Soft Sets:Application to Decision-Making Problems

In this paper, uncertainty has been measured in the form of fuzziness which arises due to imprecise boundaries of fuzzy sets. Uncertainty caused due to human’s cognition can be decreased by the use of fuzzy soft sets. There are different approaches to deal with the measurement of uncertainty. The method we proposed uses fuzzified evidence theory to calculate total degree of fuzziness of the parameters. It consists of mainly four parts.The first part is to measure uncertainties of parameters using fuzzy soft sets and then to modulate the uncertainties calculated. Afterward, the appropriate basic probability assignments with respect to each parameter are produced. In the last, we use Dempster’s rule of combination to fuse independent parameters into integrated one. To validate the proposed method, we perform an experiment and compare our outputs with grey relational analysis method. Also,a medical diagnosis application in reference to COVID-19 has been given to show the effectiveness of advanced method by comparing with other method.