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This study investigates racial and ethnic patterns in perceived non-adherence among American White, Black, Hispanic, and Asian health care users, using data from a national sample of recent health care users (N=5,124). We estimated multivariate logistic regression models of perceived non-adherence for all respondents and by respondents’ race/ethnicity. The results revealed that Blacks and Hispanics respectively had 39 percent and 36 percent lower odds of perceived non-adherence compared to Whites, but the odds of perceived non-adherence were 91 percent higher among Blacks who reported having experienced racial/ethnic bias in health care when compared to other Blacks. Good physician–patient communication was associated with a 63 percent lower odds of perceived non-adherence among Whites and Hispanics. The results suggest that compared to Whites, Blacks and Hispanics are less, not more, likely to report perceived non-adherence.

Purpose – The authors focus on understanding the relationship between costs and cost sharing on medication adherence for individuals who initiated a disease-modifying therapy (DMT) for the treatment of multiple sclerosis (MS). DMTs reduce the risk of relapse and are an essential component of MS treatment. Furthermore, the authors compare monthly payment levels for copayments versus coinsurance and estimate the effects on adherence.

Methods – Using the MarketScan Commercial Claims and Encounters database evidence from July 1 2005 to March 31 2008, the authors employ a multivariate two-stage least-squares model (2SLS) to examine the impact of copayments or coinsurance on the medication possession ratio (MPR).

Findings – Descriptive results show that the mean out-of-pocket (OOP) costs of DMT per month were higher for patients with coinsurance than for patients with copayments. For the cohort of patients with copayment there was little difference in monthly copayments across adherence thresholds. Regression analysis shows that an increase in cost sharing reduces adherence overall, but this effect was small and insignificant in the copayment cohort. In contrast, in the coinsurance cohort increased cost sharing was significantly associated with decreased adherence to DMT medication; with a 10% increase in cost sharing leading to an 8.6% decline in adherence.

Implications – Employers increasingly rely on coinsurance, despite evidence that reliance on coinsurance results in lower adherence. Our research findings suggest that coinsurance appears to be a greater obstacle to compliance, confirming predictions found in the theoretical literature.

Originality – This research converted counts of injectable treatments into a continuous adherence measure. Previous literature on cost sharing did not examine MS.

Many studies revealed positive health impacts of the Mediterranean diet (MedDiet), especially on metabolic disorders. Conversely, in Lebanon, recent information about determinants of adherence to the MedDiet are limited. This study aimed to examine the individual determinants of MedDiet adherence among adults in Lebanon.

A cross-sectional study was carried out during July 2021 among a convenient sample of 326 Lebanese adults. Data from participants were collected via an online survey developed by study researchers, composed of two well-structured questionnaires: a background questionnaire and a 14-item Mediterranean Diet Adherence Screener (14-MEDAS).

The mean MedDiet score in the total sample was 7.59 ± 2.22, reflecting moderate/fair MedDiet adherence. Consumption of fruits, vegetables, legumes and olive oil met the recommended MedDiet intake among most participants. Older age and having a regular routine of physical activity emerged as significant independent determinants of better MedDiet adherence.

Future public health interventions aiming at promoting MedDiet adherence shall target predominantly younger age groups of the Lebanese population and incorporate strategies to boost physical activity among target groups.

Knowledge workers live and work in a technology-enabled, push-notification world full of interruptions that create information overload, often requiring these workers to utilize task switching as a mechanism to meet multiple competing tasks' demands. Previous research has examined both the positive and, more often, negative effects from interruptions and task switching on knowledge workers' performance. However, this paper aims to examine knowledge workers' agentic approach to managing interruption signals and consequent task switching to remain dedicated to the task at hand.

Using an inductive grounded theory approach, we analyzed data from semi-structured interviews with knowledge workers regarding their experiences with task management strategies in interruption-heavy environments.

The results indicate the emergence of a new construct that we define as “task adherence.” We identified behavioral and technological mechanisms that knowledge workers employ to adhere to tasks, and we also categorized a host of environmental, personal and task-related factors that influence a knowledge worker's task adherence level.

This study offers a novel conceptualization of key determinants of knowledge workers' task management. Through insights into how knowledge workers purposefully prepare for and address potential interruption signals, as well as manage task switching from subsequent interruptions, managers may be able to design new work processes to improve task performance.

In a world of interruptions, task adherence adds to and clarifies a missing element in the time and task management dilemma that can enhance future efforts in designing strategies that enable knowledge workers to be more productive.

This study aims to assess whether patients [who receive community pharmacy services at locations where routine medication therapy management (MTM) care is reimbursed] who were adherent to their medications generated lower inpatient hospitalization expenses.

This is a retrospective, descriptive and cross-sectional study using administrative claims data drawn from 84 community pharmacies in North Dakota. The included patients were enrolled in a Blue Cross Blue Shield of North Dakota insurance plan and were taking one or more of eight groups of medications (metformin, antidepressants, anti-asthmatics, ACEs/ARBs, beta-blockers, calcium channel blockers, diuretics and statins) commonly prescribed to treat chronic conditions filled between July 1, 2014 and June 30, 2015. Community pharmacists used software that allowed the pharmacists to provide and bill for MTM services. Data from these sources were used to calculate medication adherence and inpatient costs.

Patients prescribed a beta blocker, a calcium channel blocker, and a diuretic or an anti-diabetic medication, and those who are fully adherent to their medications were associated with significantly lower inpatient hospitalization costs (as measured by insurance payments to hospitals) as compared to non-adherent patients. Patients who were fully adherent to their medications had no statistically significant differences in patient-specific costs compared to non-adherent patients.

Patients receiving services at a community pharmacy that offers MTM services and those who were adherent to their medication regimens generate lower health care expenses. Most of the savings come from lower hospitalization expenses, rather than patient-paid expenses.

The positive outcomes demonstrated in programme efficacy trials and the apparent ineffectiveness of programmes in community settings have prompted investigators and practitioners to examine implementation fidelity. Critically important, but often overlooked, are the implementers who deliver evidence‐based programmes. This article distinguishes fidelity at the programme level from implementer fidelity. Two components of implementer fidelity are defined. It is proposed that implementer adherence and competence are related but unique constructs that can be reliably measured for training, monitoring and outcomes research. Observational measures from a school‐based preventive intervention are used to illustrate the contributions of implementer adherence and competence. Distinguishing implementer adherence to the manual from competence in programme delivery is the next step in child mental health programme implementation research.

The purpose of this study is to assess the adherence to MedDiet among adults during the COVID-19 pandemic and the economic crisis, using the validated 14-item MedDiet assessment tool.

A quantitative research approach, based on the distribution of an online survey throughout the social media platforms, via networking, was the applied method. The structure of the survey included the socio-economic and demographic data along with the weekly adherence to physical activity; and the validated MedDiet assessment tool. The target population included 1,030 Lebanese adults from all provinces. Descriptive statistics were used to explore the characteristics of the sample population. Adherence to the MedDiet was determined by the Med-Diet score ≥ 9. Significant differences among the variables and the adherence to the MedDiet were examined using the chi-square test.

Mean adherence to the MedDiet was found to be lower than an adequate score among 60.8% of participants [mean adherence 8/14 < 9 (S.D. 2.2)]. Participants from North Province, those aged 45 years and above, university graduates, participants with an average income and those who exercised for a minimum of 30 min for three times/week had a higher mean of adherence compared to other groups. Higher percentage of those who exercised had adequate adherence compared to those who exercised less or did not. More than 50% of the participants consumed olive oil, vegetables, red meat, butter/margarine, sugary drinks, commercial sweets and sofrito according to recommendations. Less than 50% of the participants consumed fruits, nuts, fish and wine according to the MedDiet standards. More men consumed fruits (55.1%), wine (21%), fish (29%) and nuts (48.5%) than women according to the MedDiet recommendations; however, more women consumed legumes (69.7%) and Sofrito (88.4%) than men, in addition more women preferred consuming chicken over meat (72.3%).

The findings call for an urgent need of spreading national awareness among adult population in Lebanon to increase the adherence to MedDiet. To add, information gained from this study serve to help understanding nutritional behavior during the COVID-19 pandemic and the economic crisis, so public health authorities can start planning to save the threatened health-care system and preserve the wellness of the population.

This study aims to examine the predictive validity of an adherence measure to Brief Parent Training (BPT) delivered in real‐world settings. BPT promotes effective parenting practices in families with children who either are at an early stage of problem behaviour development or have developed conduct problems.

In a sample of 108 families who received BPT, whether adherence predicted parenting practices and child conduct problems after intervention completion was examined.

The results showed that high ratings of adherence predicted low levels of inconsistent discipline and high levels of appropriate discipline and positive parenting. The combined effect of inconsistent discipline and positive parenting mediated the relationship between adherence and child conduct problems. When the indirect effects were separated, inconsistent discipline functioned as a mediator, whereas positive parenting did not.

Findings indicate that it is possible to develop a sound and feasible parent‐reported measure of adherence to BPT.

Multiple sclerosis (MS) is a chronic autoimmune neurological disease. Disease-modifying therapies (DMTs) are mainstay lifelong treatment with no immediate benefits observed. Adherence to treatment is necessary, however, non-adherence is common problem in MS patients. This paper aims to evaluate patient-related factors and satisfactions affecting medication adherence in Saudi MS patients and their rights to discontinue them against medical advice.

In total, 409 patients diagnosed with MS, using self-administered DMT (oral and injectable), were randomly enrolled in a cross-sectional study. Electronic questionnaire was used in data collection.

Most participants (71.1%) did not know about their MS type. Average age of participants when diagnosed with MS was 27.9 ± 8 years (range 7–69), mean disease duration was 8.1 ± 6.6. Most patients received injectable therapy 363 (88%). Overall adherence in our sample was 67%. Age of participants and duration of disease had no impact on treatment adherence. No significant differences found between genders, educational level, marital status, and smoking in relation to treatment adherence. Route of administration did not reach statistical significance despite a higher percentage of adherence reported in patients on oral DMT [33% (n = 15)] versus injectable therapy [29% (n = 104)]. Conversely, there was significant difference between adherent and non-adherent patients according to anxiety (p = 0.002) and family history of MS (p = 0.011).

The results revealed that the age of the participants and the duration of the disease had no impact on adherence to treatment.

The purpose of this study is to identify patient experience unique to online pharmacy services (OPS) based on the characteristics of OPS (i.e. interactivity and virtuality) and to reveal how patient experience is derived from OPS and thereby enhances patient adherence from both online social support and patient experience perspectives.

The Stimulus-Organism-Response framework was used to conceptualize this study; both primary and secondary data for 296 validated participants were collected on a real OPS platform. A structural equation modeling approach combined with partial least squares was employed for the quantitative analysis.

Social presence and user engagement can be identified as patient experience in the OPS context; online emotional support has a stronger association with patients' social presence than it does with patients' user engagement; patients' social presence has a stronger association with their medication adherence than it does with diet adherence, while patients' user engagement has a stronger association with their diet adherence than it does with medication adherence; patients' medication knowledge negatively moderates the relationship between user engagement and diet adherence.

This study identifies patient experience in accordance with unique characteristics of OPS, and it reveals the nuanced underlying mechanisms by which online social support is associated with patient experience and by which patients' experience is associated with their adherence. This study enriches the literature on patient adherence, patient experience and OPS, providing insights for healthcare providers, OPS designers and policymakers.