Poor medication Adherence is a widespread problem that undermines the potential benefits of medical Treatment. Low Adherence rates in chronic disease have a substantial economic impact, estimated at $100 to $300 billion annually. Adherence rates to oral hypoglycemic agents (OHAs) and insulin injections in type 2 diabetic patients ranged from 36 to 93%. Diabetes regimens contain many aspects that make compliance difficult; it is a chronic disorder, lifestyle changes are required, and treat-ment may be complex, intrusive and inconvenient. In the face of failure to achieve the therapeutic goals instead of changing prescriptions, increasing drug dosage, or switching or adding medications, clinicians should consider counseling patients on how to improve Adherence. Understanding ‘stages of change’ and the cognitive, emotional, behavioral and social factors involved in the process of diabetes self-management, assessing depression, anxiety, eating disorders and extreme fear of ‘hypos’, educating patients, keeping regimens as simple as possible, negotiating priorities, addressing incorrect beliefs about Treatment, helping patients resolve their ambivalence, highlighting the importance of a problem solving approach for setting realistic, personalized goals, monitoring Adherence and attendance at appointments, and reinforcing the patient’s efforts to adhere at each visit provide practical and effective help. Diabetes care and counseling can be success-ful only when tailored to the needs of the individual.

BACKGROUND: Hypertension (HTN) is a public concern and Treatment Adherence has a key role in its management. This study was conducted to develop and test the reliability and validity of the Hypertensive Treatment Adherence scale (HTA-scale). METHODS: This was a cross-sectional and methodological study. After item generation using a qualitative study and literature review, the scale was developed. The psychometric properties of the scale were evaluated using face, content, construct, and criterion validity and reliability. RESULTS: Data analysis showed that the HTA-scale had acceptable face and content validity. The scale had excellent stability [Intraclass correlation coefficient (ICC) = 0. 74] and good acceptability and internal consistency (Cronbach's  = 0. 76). Exploratory factor analysis (EFA) showed that the HTA-scale consisted of 6 meaningful subscales including medication Adherence and monitoring, Adherence to safe diets, avoiding unsafe diets, self-medication, activity, and smoking. Participants in the controlled blood pressure group had significantly higher HTA-scale scores than the uncontrolled blood pressure group. At the cut-off point of 86, the scale had significant sensitivity and specificity. CONCLUSION: All of the psychometric properties of the HTA-scale achieved the standard level and were sufficient to recommend this scale for patients with HTN.

Background: Vitiligo is an acquired, auto-immune chronic skin disorder with different Treatment modalities. Insufficient Adherence to Treatment is closely related to the efficacy of a prescribed Treatment, and also, there are some associations between Adherence behaviour and personality. Therefore, the study aimed to assess a relationship between five-factor personality traits and Treatment Adherence in patients with vitiligo. Methods: In this cross-sectional study, patients with vitiligo who received Ultraviolet B (UVB) phototherapy were recruited. The Morisky Medication Adherence Scale (MMAS-8) assessed Treatment Adherence, and personality factors were evaluated by NEO Five-Factor Personality Inventory (NEO-FFI). Data were analysed using t-tests, correlations, and multiple regression. Results: Among 70 participants, 62. 9% had low Adherence, 24. 3% had medium Adherence, and 12. 9 % had high Adherence. There was a positive correlation between neuroticism (p<0. 001) and Adherence score. Furthermore, a negative correlation between Agreeableness (p=0. 13), Conscientiousness (p<0. 001), Openness to experiences (p=005), Extraversion (p<0. 001), and Adherence score was obtained. In the regression analysis method, only the factors of neuroticism (p<0. 001) and openness ( p=0. 001), and conscientiousness ( p=0. 016) predicted the dependent variable (Adherence score) at the significance level. Conclusion: This study demonstrated that openness to experience and conscientiousness positively affected Adherence, while Neuroticism negatively affected Adherence. Considering these personality factors can effectively screen poor Adherence and improve Treatment Adherence.

Objectives: The present study aimed to investigate medication Adherence awareness among women undergoing infertility Treatment. Materials and Methods: Several databases were searched including PubMed, Embase, CINAHL, PsycINFO, as well as ProQuest dissertations in order to collect the required data. In addition, based on the purpose of the study, English-language prospective, retrospective, observational, cross-sectional, quasi-experimental, and randomized controlled trial studies were selected which focused on medication Adherence as a primary or secondary outcome in women with a diagnosis of infertility. Finally, critical appraisal for the quality of the study was assessed using Downs and Black Quality Checklist (1998) and STROBE guidelines. Results: Three studies conducted during 1993-2011 were analyzed. Further, sample sizes varied from 30 to 626 subjects with average rates of oral medication Adherence ranging from 26% to 81% when used as the first-line therapy. More frequent daily dosing was associated with lower Adherence rates. Based on the results, Adherence was significantly lower when women were concerned about the side effects of medication Adherence or reported 3 or more side effects rather than one or 2 cases. Furthermore, women with a body mass index of <23 kg/m² or those who viewed medical Treatment as convenient had higher Adherence rates. It is noteworthy that none of the studies evaluated medication Adherence during controlled ovarian hyperstimulation (COH) cycles, along with intrauterine insemination (IUI) or in vitro fertilization (IVF). Conclusions: In general, rates of oral medication Adherence are found suboptimal when used alone as first-line therapy. Accordingly, further studies regarding medication-taking behaviors are warranted in future research trials involving injection medications and COH cycles associated with IUI and IVF cycles in order to strengthen the clinical practice.

Background: Hypertension is a major public health issue. With regard to the current trend, it has been estimated that one out of three people will be suffering from hypertension by 2025. This study was designed to provide a better insight into the Adherence to Treatment and its underlying reasons. Methods: A directed qualitative content analysis approach was conducted in collaboration with 35 hypertensive patients and 3 cardiologists in the form of in-depth interviews and focused group discussions from October 2015 to February 2016. Sampling was carried out from patients with hypertension using purposeful and heterogeneous method. Some of the PRECEDE model structures were applied as the conceptual framework. Results: The reasons affecting Adherence to hypertension Treatment were analyzed in three general categories of predisposing, enabling and reinforcing factors based on the model structures. Factors such as “ knowledge” , “ belief and attitude” , “ mental-personality traits” , “ culture and lifestyle” were classified as the predisposing factors category. “ Access to health service” and “ access to facilities in the workplace, home and society” were fit in the enabling factor category. The reinforcing factors category addresses “ individuals’ internal incentives” and “ family and health service providers’ support” . Conclusion: Several reasons account for non-Adherence to Treatment in hypertensive patients. Diversity of these reasons is an indication that design and implementation of different kinds of interventions are required in order to increase the patients’ awareness, empower them and encourage self-efficacy.