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Scoping Review
The Role of Pharmacists’ Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review
Iin Ernawati, Nanang Munif Yasin, Ismail Setyopranoto, Zullies Ikawati
J Prev Med Public Health. 2024;57(3):212-222.   Published online April 25, 2024
DOI: https://doi.org/10.3961/jpmph.23.592
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AbstractAbstract AbstractSummary PDF
Objectives
Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence.
Methods
A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results.
Results
The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions.
Conclusions
Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients’ knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.
Summary
Key Message
Epilepsy is a chronic neurological disease that requires long-term treatment and support from health workers, including pharmacists. Pharmacists can provide interventions independently or in collaboration with other health workers, including treatment education through counseling (essential information about the condition, insights into epilepsy, seizure triggers, and antiepileptic drugs) and education and training with therapy-based behavioral interventions (reminders and skill-based psychological support). Pharmacist intervention is known to increase medication adherence, which is an important factor in the success of therapy for epilepsy patients and can improve other therapy outcomes such as increasing knowledge of epilepsy, seizure control, and quality of life.
Systematic Review
Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis
Suchitra Hudrudchai, Charin Suwanwong, Pitchada Prasittichok, Kanu Priya Mohan, Nopphadol Janeaim
J Prev Med Public Health. 2024;57(1):8-17.   Published online December 12, 2023
DOI: https://doi.org/10.3961/jpmph.23.345
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors.
Methods
The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale.
Results
Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM.
Conclusions
Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.
Summary
Key Message
This systematic review and meta-analysis confirmed that factors such as education, number of sexual partners, engagement in sexual activities with an HIV-positive partner, substance use, and lower levels of depression were associated with higher rates of PrEP adherence among MSM. Healthcare providers and interventions should take these aspects into consideration when developing strategies to promote optimal PrEP adherence and reduce the risk of HIV transmission.
Original Article
Multilevel Analysis of the Relationship Between Prescribing Institutions and Medication Adherence Among Patients With Hypertension and Diabetes in Korea
Haryeom Ghang, Juhyang Lee
J Prev Med Public Health. 2023;56(6):504-514.   Published online October 5, 2023
DOI: https://doi.org/10.3961/jpmph.23.252
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  • 98 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes.
Methods
This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients’ first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%.
Results
The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples.
Conclusions
This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.
Summary
Korean summary
2019년 일반건강검진을 통해 발견된 고혈압과 당뇨병의 신규 환자를 대상으로 복약순응도를 분석하였다. 그 결과 검진 후 첫번째 처방기관이 의원인 경우에 비해 다른 종별 의료기관인 경우 복약순응 오즈비가 모두 감소하였는데 상급종합병원이 가장 낮았고(고혈압 0.30, 당뇨병 0.45), 그 다음은 검진전문의원인 것으로 나타났다(고혈압 0.51, 당뇨병 0.46).
Key Message
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes using general health screening data in Korea in 2019. The results showed that with clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes).

JPMPH : Journal of Preventive Medicine and Public Health