Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several...Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.展开更多
Background: breast cancer because of radiotherapy and/or chemotherapy causes cardiac disease, often it occurs on women just affected by hypertension and/or diabetes. All these conditions may affect left ventricular (L...Background: breast cancer because of radiotherapy and/or chemotherapy causes cardiac disease, often it occurs on women just affected by hypertension and/or diabetes. All these conditions may affect left ventricular (LV) geometry, mass and diastolic function. The purpose of this study is to early detect these affections to improve heart failure prevention. Patients and methods: 134 women, affected by breast cancer, underwent to conventional transthoracic echocar-diography (TTE) and pulse wave tissue Doppler imaging (PW-TDI). A control group (CG) of 80 women unaffected by breast cancer, hypertension and diabetes was enrolled. Results: 54 of 134 women (40.2%), were affected by hypertension or diabetes too (Prone Group = PG), 8 by both, 80 (59.8%) were free (FG). Mean age of all patients was 45.4 years. The rates of LV eccentric hypertrophy and LV distolic dysfunction were statistically significant higher on FG group than controls, and on PG group than FG group. Conclusions: an abnormal LV diastolic function is more common among women affected by breast cancer after treatment than in general population, the same for LV eccentric hypertrophy but at a lower rate. 40% of women were affected by hypertension, diabetes or both, and as expected they have a higher rate of LV eccentric hypertrophy and diastolic dysfunction. This high prevalence of LV eccentric hypertrophy and diastolic dysfunction, on asymptomatic women, affected by breast cancer, is a predictor of heart failure;Doppler-echo techniques may be helpful in early diagnosis.展开更多
文摘Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.
文摘Background: breast cancer because of radiotherapy and/or chemotherapy causes cardiac disease, often it occurs on women just affected by hypertension and/or diabetes. All these conditions may affect left ventricular (LV) geometry, mass and diastolic function. The purpose of this study is to early detect these affections to improve heart failure prevention. Patients and methods: 134 women, affected by breast cancer, underwent to conventional transthoracic echocar-diography (TTE) and pulse wave tissue Doppler imaging (PW-TDI). A control group (CG) of 80 women unaffected by breast cancer, hypertension and diabetes was enrolled. Results: 54 of 134 women (40.2%), were affected by hypertension or diabetes too (Prone Group = PG), 8 by both, 80 (59.8%) were free (FG). Mean age of all patients was 45.4 years. The rates of LV eccentric hypertrophy and LV distolic dysfunction were statistically significant higher on FG group than controls, and on PG group than FG group. Conclusions: an abnormal LV diastolic function is more common among women affected by breast cancer after treatment than in general population, the same for LV eccentric hypertrophy but at a lower rate. 40% of women were affected by hypertension, diabetes or both, and as expected they have a higher rate of LV eccentric hypertrophy and diastolic dysfunction. This high prevalence of LV eccentric hypertrophy and diastolic dysfunction, on asymptomatic women, affected by breast cancer, is a predictor of heart failure;Doppler-echo techniques may be helpful in early diagnosis.
