Magister Curationis - MCur / There is a growing burden of disease associated with mental disorders especially in low and middle-income countries. This growing burden is accompanied by an increase in psychotic disorders and has increased the demand for antipsychotic medication. The increase in the use of antipsychotic medication has resulted in the increase in side-effects that have a detrimental effect on the health of the mental health care user. Antipsychotic medication side-effects have been classified as the primary indicator for medication non-adherence. There is a relationship between psychiatric nurses’ knowledge and attitudes towards the use and the non-adherence of antipsychotic medication.

No description available.

archives@tulane.edu / Background Few studies have examined the association between parenting quality and behavioral adjustment in children and asthma incidence. Medication non-adherence is a proposed mechanism for the association between caregiver stress and asthma morbidity, but research on the association is limited. Aims To examine the association between parent-child relationship and child’s behavioral adjustment and asthma incidence, and to explore the association between caregiver stress and medication non-adherence in children with asthma. Methods Secondary analyses were conducted in two study populations: a birth cohort study in the United Kingdom and an intervention trial of children with asthma in inner-city New Orleans. The first two analyses defined asthma by parent report and current asthma medication use at five or seven years. Mother-child relationship and child’s behavioral adjustment were measured with the Child-Parent Relationship Scale (CPRS) and the Strengths and Difficulties Questionnaire (SDQ), respectively, at three years. Caregiver stress and medication non-adherence were measured using Cohen’s Perceived Stress Scale (PSS-4) and caregiver self-report, respectively, at baseline and twelve months. Results Among families with the most major life events, children with mothers reporting poorest compared to best CPRS had an adjusted OR=2.8 (95% CI: 2.3-3.6) for asthma. Adjusted odds ratios for the association between abnormal versus normal SDQ at 3 years and asthma at 5 or 7 years was 1.2 (95% CI: 1.0-1.5). Adjusted odds ratios for non-adherence due to running out of medications were 6.8 (95% CI: 1.0-47.6) in high versus normal stress caregivers. Conclusions Increased risk of asthma was observed among those with the poorest mother-child relationships and the most major life events, and in children with abnormal behavioral adjustment. A statistically significant adjusted association between caregiver stress and overall medication non-adherence was not observed, but an association between increased caregiver stress and non-adherence due to running out of medications was suggested. / 1 / Fritha Morrison

This study sought to appreciate the influence of antiretroviral medications on the daily lives of children in Botswana. The aim of the study was to explore and gain in-depth understanding of the influence that antiretroviral medications have on the children’s lives. The study focused on children receiving services from the Bamalete Lutheran Hospital in Ramotswa, Botswana. It is important to give children an opportunity to have their voices heard as not doing so might present missed opportunities for the various care and support services providers. The study was qualitative as it sought to come closer to the individual children and get their own personal perspective of the influence of medication on their lives. The phenomenological strategy was applied to derive the description from each participant. Although the study was mainly applied as hoping to add a dimension of the meaning of antiretroviral medication from the children’s perspective which would facilitate improvements on service delivery; it can also be seen to contribute toward the body of knowledge as there are limited literature resources in this area. The sampling method used in this study was purposive in order to ensure a variety of responses and an enriched understanding of how the participants perceived the influence of these medications. A few broad areas of discussion were developed to facilitate the one-to-one unstructured interview. The conclusion from this study is that children do have stories to share in terms of how they perceive the influence of antiretroviral medications in their lives. These stories need to be explored and understood to facilitate better targeted care and support services for them. The stories from the sixteen children interviewed in this study are herein reported as well as the conclusions and recommendations that followed them. The general theme from listening to the stories of the children is that children understand that they have to take the medications and that it helps to improve their health. / Dissertation (MSW)--University of Pretoria, 2010. / Social Work and Criminology / unrestricted

This study examined psychotropic medication claims in a sample of Protestant clergy. It estimated the proportion of clergy in the sample who had a claim for psychotropic medication (i.e., anti-depressants and anxiolytics) in 2005 and examined associations between sociodemographic characteristics, occupational distress and having a claim. Protestant clergy (n = 749) from nine denominations completed a mail survey and provided access to their pharmaceutical records. Logistic regression models assessed the effect of sociodemographic characteristics and occupational distress on having a claim. The descriptive analysis revealed that 16 % (95 % Confidence interval [CI] 13.3 %-18.5 %) of the clergy in the sample had a claim for psychotropic medication in 2005 and that, among clergy who experienced frequent occupational distress, 28 % (95 % CI 17.5 %-37.5 %) had a claim. The regression analysis found that older clergy, female clergy, and those who experienced frequent occupational distress were more likely to have a claim. Due to recent demographic changes in the clergy population, including the increasing mean age of new clergy and the growing number of female clergy, the proportion of clergy having claims for psychotropic medication may increase in the coming years. To the best of our knowledge, this is the first study to examine the use of psychotropic medication among clergy.

This study examined psychotropic medication claims in a sample of Protestant clergy. It estimated the proportion of clergy in the sample who had a claim for psychotropic medication (i.e., anti-depressants and anxiolytics) in 2005 and examined associations between sociodemographic characteristics, occupational distress and having a claim. Protestant clergy (n = 749) from nine denominations completed a mail survey and provided access to their pharmaceutical records. Logistic regression models assessed the effect of sociodemographic characteristics and occupational distress on having a claim. The descriptive analysis revealed that 16 % (95 % Confidence interval [CI] 13.3 %-18.5 %) of the clergy in the sample had a claim for psychotropic medication in 2005 and that, among clergy who experienced frequent occupational distress, 28 % (95 % CI 17.5 %-37.5 %) had a claim. The regression analysis found that older clergy, female clergy, and those who experienced frequent occupational distress were more likely to have a claim. Due to recent demographic changes in the clergy population, including the increasing mean age of new clergy and the growing number of female clergy, the proportion of clergy having claims for psychotropic medication may increase in the coming years. To the best of our knowledge, this is the first study to examine the use of psychotropic medication among clergy.

OBJECTIVE:: Evidence-based interventions for pill swallowing training exist but are primarily implemented in pediatric specialty hospitals. Given increasing interest in the translation of brief and effective interventions to the wider population, there is a need to examine medication acceptance in a normative sample. METHODS:: Participants (N ≤ 304) completed the Medication Acceptance Survey, which assessed child/adolescent liquid and pill medication history and acceptance as well as parental interest in pill swallowing training. RESULTS:: Results showed that 30 "40% of youth had rejected/refused a pill or liquid formulation. Over half were unable to swallow a standard size pill or small capsule. Despite these difficulties, most parents did not express interest in an empirically supported pill swallowing training intervention. CONCLUSIONS:: The results provide directions for future research as well as the translation of pill swallowing interventions to primary care.

This study examined the state of the literature on the effectiveness of medication assisted treatment (MAT; methadone, buprenorphine, naltrexone) delivered in prisons and jails on community substance use treatment engagement, opioid use, recidivism, and health risk behaviors following release from incarceration. Randomized controlled trials (RCTs) and quasi-experimental studies published through December 2017 that examined induction to or maintenance on methadone (n = 18 studies), buprenorphine (n = 3 studies), or naltrexone (n = 3 studies) in correctional settings were identified from PsycINFO and PubMed databases. There were a sufficient number of methadone RCTs to meta-analyze; there were too few buprenorphine or naltrexone studies. All quasi-experimental studies were systematically reviewed. Data from RCTs involving 807 inmates (treatment n = 407, control n = 400) showed that methadone provided during incarceration increased community treatment engagement (n = 3 studies; OR = 8.69, 95% CI = 2.46; 30.75), reduced illicit opioid use (n = 4 studies; OR = 0.22, 95% CI = 0.15; 0.32) and injection drug use (n = 3 studies; OR = 0.26, 95% CI = 0.12; 0.56), but did not reduce recidivism (n = 4 studies; OR = 0.93, 95% CI = 0.51; 1.68). Data from observational studies of methadone showed consistent findings. Individual review of buprenorphine and naltrexone studies showed these medications were either superior to methadone or to placebo, or were as effective as methadone in reducing illicit opioid use post-release. Results provide the first meta-analytic summary of MATs delivered in correctional settings and support the use of MATs, especially with regard to community substance use treatment engagement and opioid use; additional work is needed to understand the reduction of recidivism and other health risk behaviors.

Objectives This study is a follow-up to previous research regarding buprenorphine medication-assisted therapy (MAT) in Johnson City, Tennessee. For-profit MAT clinics were surveyed to determine changes in tapering practice patterns and insurance coverage during the last 3 years. Methods Johnson City for-profit MAT clinics; also called office based opioid treatment centers, were surveyed by telephone. Clinic representatives were asked questions regarding patient costs for therapy, insurance coverage, counseling offered onsite, and opportunities for tapering while pregnant. Results All of the MAT clinics representatives indicated that tapering in pregnancy could be considered even though tapering in pregnancy is contrary to current national guidelines. Forty-three percent of the clinics now accept insurance as compared with 0% in the 2016 study. The average weekly cost per visit remained consistent. Conclusions The concept of tapering buprenorphine during pregnancy appears to have become a standard of care for this community, as representatives state it is offered at all of the clinics that were contacted. Representatives from three clinics stated the clinics require tapering, even though national organizations such as the American College of Obstetricians and Gynecologists and the American Society of Addiction Medicine do not recommend this approach. Although patients who have government or other insurance are now able to obtain buprenorphine with no expense at numerous clinics, the high cost for uninsured patients continues to create an environment conducive to buprenorphine diversion.

Magister Pharmaceuticae - MPharm / Medication labels are often the only information available to patients after obtaining medication 3 from the pharmacy or other healthcare practitioners. Inappropriately designed medicine labelling 4 contributes to poor interpretation and improper use, which could adversely affect patient health 5 outcomes. In developing countries, pictograms (pictures representing words or phrases), on 6 medicine labels tend to support patients’ ability to read, understand and recall information. 7 8 Objective 9 This comparative study examined low-literate participants’ interpretation of ‘text-and-pictogram’ 10 instructions versus ‘routine text-only’ instructions relative to the intended medicine use 11 instructions on an oral rehydration (OR) dry mixture sachet in public sector Community Health 12 Centres (CHCs) in Cape Town