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Malaeb D, Sacre H, Mansour S, Haddad C, Sarray El Dine A, Fleihan T, Hallit S, Salameh P, Hosseini H. Assessment of medication adherence among Lebanese adult patients with non-communicable diseases during COVID-19 lockdown: a cross-sectional study. Front Public Health 2023; 11:1145016. [PMID: 37415710 PMCID: PMC10322190 DOI: 10.3389/fpubh.2023.1145016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/25/2023] [Indexed: 07/08/2023] Open
Abstract
Background Medical treatment is considered a cornerstone in non-communicable diseases (NCDs) management, lack of adherence remains the main challenge that may compromise optimal therapeutic outcome achievement. Purpose This study aimed to evaluate treatment adherence levels and associated factors among Lebanese adult patients with non-communicable diseases. Materials and methods A cross-sectional survey conducted during the COVID-19 lockdown imposed by the Lebanese Government (between September 2020 and January 2021) enrolled 263 adult patients through an anonymous online questionnaire to assess adherence to medications using the Lebanese Medication Adherence Scale (LMAS-14). Results Of the total sample, 50.2% showed low adherence with a total mean adherence score of 4.41 ± 3.94. The results showed that depression (β = 1.351) and peptic ulcer (β = 1.279) were significantly associated with higher LMAS scores (lower adherence). However, age between 50 and 70 (β = -1.591, p = 0.011), practicing physical exercise (β = -1.397, p = 0.006), having kidney disease (β = -1.701, p = 0.032), and an intermediate (β = -1.336, p = 0.006) to high income (β = -3.207, p < 0.001) were significantly associated with lower LMAS scores (higher adherence). Conclusion Our study shed light on the factors affecting medication adherence in patients with non-communicable diseases. It showed that depression and peptic ulcer were associated with lower adherence, contrary to older age, exercising, having chronic kidney disease, and a higher socioeconomic status.
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Affiliation(s)
- Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon
| | | | - Tamara Fleihan
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hassan Hosseini
- INSERM U955-E01, IMRB, Henri Mondor Hospital, Créteil, France
- Department of Neurology, Henri Mondor Hospital, AP-HP, Créteil, France
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Persson CU, Svärdsudd K, Rusek L, Blomstrand C, Blomstrand A, Welin L, Wilhelmsen L, Hansson PO. Determinants of Stroke in a General Male Population. Stroke 2018; 49:2830-2836. [DOI: 10.1161/strokeaha.118.022740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
To further improve preventive strategies against stroke, there is a need for epidemiological long-term studies. The study aimed at a prospective investigation of stroke determinants in the general male population.
Methods—
During a period of 48 years, from 50 to 98 years of age, a population-based sample of 854 men was followed using repeated medical examinations, lifestyle questionnaires, data from hospital records and the National Cause of Death Register.
Results—
Determinants of ischemic stroke were atrial fibrillation (hazard ratio [HR], 6.61; 95% CI, 4.47–9.77); mother dead from cardiovascular disease (HR, 1.53; 1.09–2.17); high education (HR, 0.81; 0.69–0.96); and high physical activity level during leisure time (HR, 0.68; 0.50–0.93). For hemorrhagic stroke heart rate (HR, 1.04; 1.01–1.06) and mother dead from stroke (HR, 3.56; 1.43–8.87) constituted an increased risk. Statistically significant determinants for all stroke were atrial fibrillation (HR, 5.34; 3.68–7.75); high diastolic blood pressure (HR, 1.02; 1.01–1.03); high body weight (HR, 0.96; 0.94–0.99); high educational level (HR, 0.79; 0.68–0.92); wide waist circumference (HR, 1.04; 1.01–1.07); smoking (HR, 1.25; 1.06–1.48); mother dead from cerebrovascular disease (HR, 1.43; 1.05–1.94); and diabetes mellitus (HR, 1.65; 1.02–2.68). Of all men diagnosed with atrial fibrillation, 88% had a stroke during follow-up.
Conclusions—
Atrial fibrillation was by far the strongest determinant of stroke during 48 years of follow-up in a male population sample followed until the age of 98 years. The results warrant improved prophylaxis through intense treatment of modifiable determinants.
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Affiliation(s)
- Carina U. Persson
- From the Department of Clinical Neuroscience, Rehabilitation Medicine, Institution of Neuroscience and Physiology (C.U.P.), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Kurt Svärdsudd
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Sweden (K.S.)
| | - Linnéa Rusek
- Department of Molecular and Clinical Medicine, Institute of Medicine (L.R., P.-O.H., L. Wilhelmsen), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Christian Blomstrand
- Department of Clinical Neuroscience and Stroke Centre West, Institution of Neuroscience and Physiology (C.B.), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ann Blomstrand
- Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine (A.B.), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Lennart Welin
- Department of Medicine, Lidköping Hospital, Sweden (L. Welin)
| | - Lars Wilhelmsen
- Department of Molecular and Clinical Medicine, Institute of Medicine (L.R., P.-O.H., L. Wilhelmsen), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Per-Olof Hansson
- Department of Molecular and Clinical Medicine, Institute of Medicine (L.R., P.-O.H., L. Wilhelmsen), Sahlgrenska Academy, University of Gothenburg, Sweden
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Paraskevas KI, Mikhailidis DP, Veith FJ, Spence JD. Definition of Best Medical Treatment in Asymptomatic and Symptomatic Carotid Artery Stenosis. Angiology 2015; 67:411-9. [PMID: 26721504 DOI: 10.1177/0003319715624526] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Implementation of best medical treatment (BMT) is the cornerstone of the management of patients with either asymptomatic or symptomatic carotid artery stenosis. We review the literature to define the components of BMT. Smoking cessation, maintaining a healthy body weight, moderate exercise, and a Mediterranean diet are essential lifestyle measures. Moderate alcohol consumption may also be beneficial but recommending it to patients may be hazardous if they consume too much. The importance of lifestyle measures is largely underestimated by both physicians and patients. Blood pressure and diabetes control, antiplatelet agents, and lipid-lowering treatment with statins/ezetimibe comprise the pharmacological components of BMT. Initiation of an intensive regimen of BMT is a sine qua non for patients with carotid artery stenosis whether or not they are offered or undergo an invasive revascularization procedure.
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Affiliation(s)
- Kosmas I Paraskevas
- Department of Vascular Surgery, Southampton University Hospital, Southampton, United Kingdom
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, United Kingdom
| | - Frank J Veith
- Division of Vascular Surgery, New York University Langone Medical Center, New York, NY, USA Division of Vascular Surgery, The Cleveland Clinic, Cleveland, OH, USA
| | - J David Spence
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
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4
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Sarikaya H, Ferro J, Arnold M. Stroke Prevention - Medical and Lifestyle Measures. Eur Neurol 2015; 73:150-7. [DOI: 10.1159/000367652] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 08/17/2014] [Indexed: 11/19/2022]
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Derdeyn CP, Fiorella D, Lynn MJ, Turan TN, Lane BF, Janis LS, Chimowitz MI. Intracranial stenting: SAMMPRIS. Stroke 2013; 44:S41-4. [PMID: 23709726 DOI: 10.1161/strokeaha.111.000370] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Colin P Derdeyn
- Mallinckrodt Institute of Radiology and the Departments of Neurology and Neurosurgery, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO, USA.
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Sander D, Poppert H, Sander K, Etgen T. Primärprävention des Schlaganfalls – Was ist neu? AKTUELLE NEUROLOGIE 2011. [DOI: 10.1055/s-0031-1295470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- D. Sander
- Klinik für Neurologie, Benedictus Krankenhaus Tutzing
- Neurologische Klinik des Klinikums rechts der Isar, Technische Universität München
| | - H. Poppert
- Neurologische Klinik des Klinikums rechts der Isar, Technische Universität München
| | - K. Sander
- Neurologische Klinik des Klinikums rechts der Isar, Technische Universität München
- Klinik für Psychosomatik, Schön Klinikum Berchtesgadener Land
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Sharma M, Hakim AM. The management of hypertension for primary stroke prevention: a proposed approach. Int J Stroke 2011; 6:144-9. [PMID: 21371277 DOI: 10.1111/j.1747-4949.2010.00569.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The prevalence of hypertension in society is high and increasing. Untreated hypertension results in stroke, dementia, and damage to major organs. This article reviews the risks that hypertension causes and the issues now generally accepted as playing a role in the low level of hypertension control. These include lack of public awareness of the significance of elevated blood pressure, lack of impetus to measure blood pressure, lack of sites to perform the measurements, occasional therapeutic inertia on the part of the medical community, and poor compliance with treatment on the part of affected individuals. Innovative measures that may result in improved management of this risk factor are discussed. These include ubiquitous blood pressure measurement sites, expanding therapeutic potential by involving allied health professionals, and offering rewards for treatment and for compliance. The article also emphasises that the ideal blood pressure target for the primary prevention of stroke remains unclear.
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Affiliation(s)
- Mukul Sharma
- Regional Stroke Program, Ottawa Hospital, Civic Campus, Ottawa, ON, Canada
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Zibadi S, Farid R, Moriguchi S, Lu Y, Foo LY, Tehrani PM, Ulreich JB, Watson RR. Oral administration of purple passion fruit peel extract attenuates blood pressure in female spontaneously hypertensive rats and humans. Nutr Res 2007. [DOI: 10.1016/j.nutres.2007.05.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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