Adherence Patient

Oral chemotherapy is a convenient and flexible option for cancer treatment that can improve patients quality of life and increase adherence to treatment compared to traditional intravenous chemotherapy. However, since patients are responsible for taking the medication, there can be issues with continuity and adherence. Like other medications, generics of existing oral chemotherapy have emerged, which help reduce costs and improve access to this therapy. These generics contribute to a more sustainable healthcare system, so it is necessary to implement effective strategies for their adoption. Although generic treatments have been shown to be just as effective as the original drug, there is no regulation requiring the pill to have the same shape and color as the original (what we refer to as appearance). Additionally, the packaging of the treatment is different as it is specific to each brand. Therefore, a patient on a specific treatment may switch from the original medication to a generic or from one generic to another, which may have a different appearance in both the pill and the packaging. It has been observed that these changes can lead to medication errors or a loss of patient confidence, resulting in decreased continuity and adherence to treatment. These issues have been seen with other medications for chronic diseases but have not been studied in cancer patients to date. In these patients, despite the nature of the disease suggesting they would be adherent to treatment, previous studies have shown that this is not the case, with only about 70% of patients being adherent. This lack of adherence affects treatment efficacy, increases the risk of disease relapse, and therefore negatively impacts patient s quality of life and survival while also increasing costs. Therefore, this study focuses on evaluating whether these changes in pill appearance and/or packaging impact treatment continuity and adherence, as well as other relevant patient outcomes and their experience with the healthcare received. Additionally, we want to analyze whether there are patient variables (such as health literacy, age, or clinical variables) that influence the impact of these changes. Given the differences in adherence between men and women, it is essential to conduct these analyses separately for both genders. The results obtained from this study will contribute to the development of educational strategies for managing oral chemotherapy by patients and healthcare professionals. Additionally, new evidence will be generated to allow decision-makers to establish policies, either by choosing treatments with the least change in appearance or by regulating the appearance of treatments. All of this will contribute to greater treatment effectiveness, improved patient quality of life, and a lower rate of disease recurrence.

Can the investigators create an effective way to improve adherence to immunosuppressant medication and reduce rejection, graft loss, and death in adolescents and young adults who have undergone kidney or liver transplantation? The investigators' mobile technology intervention uses real-time electronic pillbox-assessed dose timing and text message prompts to address antirejection medication nonadherence when nonadherence is detected.

Home exercise program is recommended by physicians to patients and their relatives to do at home and It is a treatment option in which the physician describes how to do it. Home workout program to be completed at home to complement and reinforce their program in the clinic It is a personalized set of therapeutic exercises that are taught. There are factors that can change exercise compliance; There are some reasons why some patients adhere to the prescribed home exercise program and others do not. Adherence to home exercises is a major issue in rehabilitation and the reasons for this are multifactorial; It includes both psychological and specific conditions factors that vary between each individual and these conditions should be taken into account by clinicians in designing personalized exercise programs. Home exercise programs constitute a fundamental component of rehabilitation and are widely prescribed by physicians support therapeutic gains beyond the clinical environment. These individualized programs aim to maintain functional improvements, reduce symptoms, and promote self-management among individuals with musculoskeletal disorders. Although adherence to home-based exercises is recognized as a key determinant of rehabilitation outcomes, non-adherence remains a persistent challenge. Despite growing emphasis on the importance of exercise compliance, the existing literature provides relatively limited and insufficient evidence regarding the factors that influence adherence across different musculoskeletal conditions, including degenerative, orthopedic, and neurological disorders. Addressing this gap, the present prospective longitudinal cohort study aims to evaluate adherence to individualized home-based exercise programs among patients with diverse musculoskeletal conditions and to determine whether adherence behaviors differ across diagnostic groups. In addition, the study seeks to identify demographic, clinical, psychosocial, and functional factors associated with exercise compliance. By integrating structured clinical evaluations with validated outcome measures, this study aims not only to clarify the determinants of exercise adherence but also to contribute to the development of more effective, condition-specific strategies to enhance sustained engagement in home-based rehabilitation.

One significant challenge to non-invasive ventilation (NIV) use in children is finding masks to fit a wide range of growing shapes and sizes. While the technology has improved with development of masks specifically for children, the range of options remains limited. Given the smaller size relative to adults, craniofacial abnormalities and craniofacial differences are more likely to compromise mask fit for children. A poor mask fit is uncomfortable, alters delivery of airway pressure, and, in some children, leads to failure of NIV and the need for surgical insertion of an airway in the neck to deliver positive airway pressure through a tracheostomy. This makes expanding the technology to deliver NIV vital and custom NIV masks an exciting solution.In this study, this study will enroll children who are established on long-term NIV with at least some use within 3 months of starting this therapy but who have non-optimal adherence. After consenting to participate and completing demographic and health questionnaire, participants will undergo a facial scan using stereophotogrammetry. This scan will be imported into a computer-aided design software to create a NIV mask customized to the individual face. The steps of mask testing will include: i) Bench testing to compare the leak and comfort parameters of the current commercial mask used by the participant to the custom mask: ii) Efficacy of treatment as measured by polysomonography iii) NIV compliance from machine downloads; iv) Questionnaires to assess the subjective comfort, fit, and adverse events Finally, participants and their parents/guardian will be asked which mask they prefer and why.

Introduction: Regular practice of exercise or physical activity (PA) is a recognized intervention as a determinant of good health acquisition, maintenance, or recovery for a large number of chronic pathologies. Nevertheless, few studies have evaluated adherence to an initial health-adapted PA (APA) program, and persistence of active behavior over the time in individuals with a chronic disease. The aim of the study is to determine the brakes and levers associated with motivation and long-term compliance. In addition, the investigators aim to evaluate the cost-effectiveness of such program in term of care consumption. Finally, the investigators complete their interest for APA prescription from practitioners agreeing to enroll their patients in the present study. Method: The investigators perform a prospective monocentric cohort, of 2024 patients affected of a chronic disease or long-term illness (LTI), enrolled from 2021 to 2024 (4 years, 506 per year), for a 16-week APA program, and followed 5 years with an annual fitness and habits of life and care consumption evaluation.