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  1. Article ; Online: Systematic Review Examining the Behavior Change Techniques in Medication Adherence Intervention Studies Among People With Type 2 Diabetes.

    Teo, Vivien / Weinman, John / Yap, Kai Zhen

    Annals of behavioral medicine : a publication of the Society of Behavioral Medicine

    2024  Volume 58, Issue 4, Page(s) 229–241

    Abstract: Background: Although previous systematic reviews have studied medication adherence interventions among people with Type 2 diabetes (PwT2D), no intervention has been found to improve medication adherence consistently. Furthermore, inconsistent and poor ... ...

    Abstract Background: Although previous systematic reviews have studied medication adherence interventions among people with Type 2 diabetes (PwT2D), no intervention has been found to improve medication adherence consistently. Furthermore, inconsistent and poor reporting of intervention description has made understanding, replication, and evaluation of intervention challenging.
    Purpose: We aimed to identify the behavior change techniques (BCTs) and characteristics of successful medication adherence interventions among PwT2D.
    Methods: A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus. Studies were included if they were randomized controlled trials with BCT-codable interventions designed to influence adherence to anti-diabetic medication for PwT2D aged 18 years old and above and have medication adherence measure as an outcome.
    Results: Fifty-five studies were included. Successful interventions tend to target medication adherence only, involve pharmacists as the interventionist, contain "Credible source" (BCT 9.1), "Instruction on how to perform the behaviour" (BCT 4.1), "Social support (practical)" (BCT 3.2), "Action planning" (BCT 1.4), and/ or "Information about health consequences" (BCT 5.1). Very few interventions described its context, used theory, examined adherence outcomes during the follow-up period after an intervention has ended, or were tailored to address specific barriers of medication adherence.
    Conclusion: We identified specific BCTs and characteristics that are commonly reported in successful medication adherence interventions, which can facilitate the development of future interventions. Our review highlighted the need to consider and clearly describe different dimensions of context, theory, fidelity, and tailoring in an intervention.
    MeSH term(s) Humans ; Adolescent ; Diabetes Mellitus, Type 2/drug therapy ; Behavior Therapy/methods ; Medication Adherence
    Language English
    Publishing date 2024-02-09
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 632630-4
    ISSN 1532-4796 ; 0883-6612
    ISSN (online) 1532-4796
    ISSN 0883-6612
    DOI 10.1093/abm/kaae001
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  2. Article ; Online: Proceedings from the a:care congress: Adherence to medication: Time to recognise the elephant in the room.

    Tokgözoğlu, Lale / Weinman, John

    Atherosclerosis

    2022  Volume 350, Page(s) 119–121

    MeSH term(s) Medication Adherence
    Language English
    Publishing date 2022-04-29
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 80061-2
    ISSN 1879-1484 ; 0021-9150
    ISSN (online) 1879-1484
    ISSN 0021-9150
    DOI 10.1016/j.atherosclerosis.2022.04.022
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  3. Article ; Online: Observed and self-reported COVID-19 health protection behaviours on a university campus and the impact of a single simple intervention.

    Davies, Rachel / Weinman, John / Rubin, G James

    Journal of public health (Oxford, England)

    2023  Volume 45, Issue 3, Page(s) 676–679

    Abstract: During the COVID-19 pandemic, most data on adherence to health protective behaviours were collected via a self-report. We quantified the discrepancy between self-report data and discretely observed behaviour in a sample of university staff and students. ... ...

    Abstract During the COVID-19 pandemic, most data on adherence to health protective behaviours were collected via a self-report. We quantified the discrepancy between self-report data and discretely observed behaviour in a sample of university staff and students. We assessed the prevalence of cleaning hands, wearing a face-covering and maintaining distance from others. We also tested whether additional signage reminding people that these behaviours were mandatory improved observed adherence. Prevalence estimates based on self-report were higher than those based on observations. Signage was associated with improvements for observed behaviours (all χ2 ≥ 6.0, P < 0.05). We caution that self-reported data can produce misleading adherence rates.
    MeSH term(s) Humans ; COVID-19/epidemiology ; COVID-19/prevention & control ; Universities ; Self Report ; Pandemics/prevention & control ; Health Behavior
    Language English
    Publishing date 2023-01-21
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2142082-8
    ISSN 1741-3850 ; 1741-3842
    ISSN (online) 1741-3850
    ISSN 1741-3842
    DOI 10.1093/pubmed/fdac147
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  4. Article ; Online: Advancements in imaging in ChILD.

    Spielberg, David R / Weinman, Jason / DeBoer, Emily M

    Pediatric pulmonology

    2023  

    Abstract: Interstitial and diffuse lung diseases in children constitute a range of congenital and acquired disorders. These disorders present with signs and symptoms of respiratory disease accompanied by diffuse radiographic changes. In many cases, radiographic ... ...

    Abstract Interstitial and diffuse lung diseases in children constitute a range of congenital and acquired disorders. These disorders present with signs and symptoms of respiratory disease accompanied by diffuse radiographic changes. In many cases, radiographic findings are nonspecific, while in other disorders, chest computed tomography (CT) is diagnostic in the appropriate context. Regardless, chest imaging remains central in the evaluation of the patient with suspected childhood interstitial lung disease (chILD). Several newly described chILD entities, spanning both genetic and acquired etiologies, have imaging that aid in their diagnoses. Advances in CT scanning technology and CT analysis techniques continue to improve scan quality as well as expand use of chest CT as a research tool. Finally, ongoing research is expanding use of imaging modalities without ionizing radiation. Magnetic resonance imaging is being applied to investigate pulmonary structure and function, and ultrasound of the lung and pleura is a novel technique with an emerging role in chILD disorders. This review describes the current state of imaging in chILD including recently described diagnoses, advances in conventional imaging techniques and applications, and evolving new imaging modalities that expand the clinical and research roles for imaging in these disorders.
    Language English
    Publishing date 2023-05-24
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26487
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  5. Article ; Online: 'Turning up and tuning in'. Factors associated with parental non-attendance and non-adherence in intervention for young children with speech, language communication needs.

    Williams, Penny / Slonims, Vicky / Weinman, John

    International journal of language & communication disorders

    2023  Volume 59, Issue 2, Page(s) 762–778

    Abstract: Background: When parents bring their child to appointments and then adhere to agreed speech and language therapy (SLT) recommendations, there is the potential to increase the intensity of the intervention, support generalization and improve outcomes. In ...

    Abstract Background: When parents bring their child to appointments and then adhere to agreed speech and language therapy (SLT) recommendations, there is the potential to increase the intensity of the intervention, support generalization and improve outcomes. In SLT, however, little is known about factors that may promote attendance or adherence. Studies in other clinical areas such in medicine, psychology and physiotherapy have identified risk factors for non-attendance or non-adherence that are multifactorial and variable dependent on, for example, population and intervention.
    Aims: To identify rates of non-attendance and non-adherence, and to identify parent or child factors associated with parent involvement in intervention for children under 5 years of age receiving SLT.
    Methods: Parents completed questionnaires at two time points assessing the domains of parents' beliefs (problem perceptions, self-efficacy), personal circumstances (socio-demographics, family functioning), treatment experience and child factors. Predictors of parent attendance and adherence were identified through multiple regression analyses. Non-attendance rates were identified via local health records and non-adherence ascertained using a specific parent-reported measure within the treatment experience domain.
    Results: Participants (N = 199) were predominantly mothers, and were ethnically and socio-economically diverse, speaking a wide range of languages. Their children presented with a range of speech, language communication needs (SLCN). The rate of non-attendance was 25% and the main predictors of non-attendance were maternal age, education level and two factors within the parent beliefs domain. This model explained 40% of the variance in attendance. The rate of non-adherence in this cohort was 26% with parental rating of the importance of a recommendation and self-efficacy beliefs predicting adherence; this explained 56% of the variance in adherence to SLT recommendations at home.
    Conclusions & implications: Our research has provided preliminary evidence of the influence of parents' beliefs, personal circumstances and treatment experiences on their involvement in their child's therapy. Speech and language therapists should consider factors impacting attendance and adherence to treatment and explore parental perceptions of their child's SLCN before embarking on an intervention, a foundation for collaborative practice. A possible limitation of this study is that the levels of attrition in our sample led to generally high measured rates of participation, which should be considered in future studies. Future research should explore adherence in treatments with varying doses, with different types of SLCN or interventions and in different settings.
    What this paper adds: What is already known on the subject It is acknowledged that parent involvement in their child's therapy, such as attending and adhering to recommendations, is important but little is known about the rates of involvement and what factors may be associated with attendance and adherence in SLT. Qualitative research has explored parental involvement suggesting that beliefs about an intervention may be pertinent. Extensive research in other clinical areas suggest multiple and varied factors are influential and further exploration of particular populations and interventions is necessary. What this paper adds to the existing knowledge This study identified rates of parental non-attendance and non-adherence in a cohort of predominantly mothers of children under the age of 5 years. It is the first study to measure parent adherence in SLT and identify factors that are associated parental adherence to SLT recommendations. It adds to the small body of SLT specific research in understanding risk factors for non-attendance. What are the potential or actual clinical implications of this work? This study highlights the need for a speech and language therapist to consider and explore parents' perspectives of their child's SLCN as a part of achieving collaboration with a parent in order to achieve the best outcomes. It provides a foundation for further systematic research into parent involvement with the ultimate aim of enhancing outcomes for children with SLCN.
    MeSH term(s) Child ; Female ; Humans ; Child, Preschool ; Speech ; Parents/psychology ; Communication ; Speech Therapy ; Mothers
    Language English
    Publishing date 2023-10-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1415919-3
    ISSN 1460-6984 ; 1368-2822
    ISSN (online) 1460-6984
    ISSN 1368-2822
    DOI 10.1111/1460-6984.12961
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  6. Article: Improving adherence in chronic airways disease: are we doing it wrongly?

    d'Ancona, Gráinne / Weinman, John

    Breathe (Sheffield, England)

    2021  Volume 17, Issue 2, Page(s) 210022

    Abstract: Non-adherence to medicines is a significant clinical and financial burden, but successful strategies to improve it, and thus bring about significant improvements in clinical outcome, remain elusive. Many barriers exist, including a lack of awareness ... ...

    Abstract Non-adherence to medicines is a significant clinical and financial burden, but successful strategies to improve it, and thus bring about significant improvements in clinical outcome, remain elusive. Many barriers exist, including a lack of awareness amongst some healthcare professionals as to the extent and impact of non-adherence and a dearth of skills to address it successfully. Patients may not appreciate that they are non-adherent, feel they cannot disclose it or underestimate its impact on their health in the short and longer term. In describing the evidence-based frameworks that identify the causal factors behind medicines taking (or not taking) behaviours, we can start to personalise interventions to enable individuals to make informed decisions about their treatments and thus overcome real and perceived barriers to adherence.
    Educational aims: To understand the underlying principles of why a patient may or may not take medicines as agreed.To choose targeted interventions to support better adherence.
    Language English
    Publishing date 2021-01-12
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2562899-9
    ISSN 2073-4735 ; 1810-6838
    ISSN (online) 2073-4735
    ISSN 1810-6838
    DOI 10.1183/20734735.0022-2021
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  7. Article ; Online: Universal 120-kV Dual-Source Ultra-High Pitch Protocol on the Photon-Counting CT System for Pediatric Abdomen of All Sizes: A Phantom Investigation Comparing With Energy-Integrating CT.

    Zhou, Wei / Huo, Donglai / Browne, Lorna P / Zhou, Xin / Weinman, Jason

    Investigative radiology

    2024  

    Abstract: Objectives: The purpose of this study is to determine if a universal 120-kV ultra-high pitch and virtual monoenergetic images (VMIs) protocol on the photon-counting computed tomography (PCCT) system can provide sufficient image quality for pediatric ... ...

    Abstract Objectives: The purpose of this study is to determine if a universal 120-kV ultra-high pitch and virtual monoenergetic images (VMIs) protocol on the photon-counting computed tomography (PCCT) system can provide sufficient image quality for pediatric abdominal imaging, regardless of size, compared with protocols using a size-dependent kV and dual-source flash mode on the energy-integrating CT (EICT) system.
    Materials and methods: One solid water insert and 3 iodine (2, 5, 10 mg I/mL) inserts were attached or inserted into phantoms of variable sizes, simulating the abdomens of a newborn, 5-year-old, 10-year-old, and adult-sized pediatric patients. Each phantom setting was scanned on an EICT using clinical size-specific kV dual-source protocols with a pitch of 3.0. The scans were performed with fixed scanning parameters, and the CTDIvol values of full dose were 0.30, 0.71, 1.05, and 7.40 mGy for newborn to adult size, respectively. In addition, half dose scans were acquired on EICT. Each phantom was then scanned on a PCCT (Siemens Alpha) using a universal 120-kV protocol with the same full dose and half dose as determined above on the EICT scanner. All other parameters matched to EICT settings. Virtual monoenergetic images were generated from PCCT scans between 40 and 80 keV with a 5-keV interval. Image quality metrics were compared between PCCT VMIs and EICT, including image noise (measured as standard deviation of solid water), contrast-to-noise ratio (CNR) (measured at iodine inserts with solid water as background), and noise power spectrum (measured in uniform phantom regions).
    Results: Noise at a PCCT VMI of 70 keV (7.0 ± 0.6 HU for newborn, 14.7 ± 1.6 HU for adult) is comparable (P > 0.05, t test) or significantly lower (P < 0.05, t test) compared with EICT (7.8 ± 0.8 HU for newborn, 15.3 ± 1.5 HU for adult). Iodine CNR from PCCT VMI at 50 keV (50.8 ± 8.4 for newborn, 27.3 ± 2.8 for adult) is comparable (P > 0.05, t test) or significantly higher (P < 0.05, t test) to the corresponding EICT measurements (57.5 ± 6.7 for newborn, 13.8 ± 1.7 for adult). The noise power spectrum curve shape of PCCT VMI is similar to EICT, despite PCCT VMI exhibiting higher noise at low keV levels.
    Conclusions: The universal PCCT 120 kV with ultra-high pitch and postprocessed VMIs demonstrated equivalent or improved performance in noise (70 keV) and iodine CNR (50 keV) for pediatric abdominal CT, compared with size-specific kV images on the EICT.
    Language English
    Publishing date 2024-04-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80345-5
    ISSN 1536-0210 ; 0020-9996
    ISSN (online) 1536-0210
    ISSN 0020-9996
    DOI 10.1097/RLI.0000000000001080
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  8. Article ; Online: Can Smartphone Notifications Help With Gout Management? A Feasibility Study.

    Emad, Yasaman / Dalbeth, Nicola / Weinman, John / Chalder, Trudie / Petrie, Keith J

    The Journal of rheumatology

    2024  Volume 51, Issue 2, Page(s) 189–196

    Abstract: Objective: This feasibility study aimed to assess the acceptability of using smartphone notifications to modify the medication beliefs of people with gout. We evaluated the feasibility and acceptability of a smartphone application using the Technology ... ...

    Abstract Objective: This feasibility study aimed to assess the acceptability of using smartphone notifications to modify the medication beliefs of people with gout. We evaluated the feasibility and acceptability of a smartphone application using the Technology Acceptance Model. We explored adherence rate differences and outcomes between the intervention and control groups.
    Methods: Fifty-two patients with gout who were prescribed allopurinol were randomly assigned to either active control (n = 24) or intervention group (n = 28). Over 3 months, both groups used the study app on their smartphones. The active control group received notifications about general health advice, whereas the intervention group received adherence-targeted notifications. The feasibility and acceptability of the smartphone app was measured through semistructured interviews. Adherence rate was assessed through serum urate levels and missed doses at 3 timepoints: baseline, 3 months (post intervention), and 6 months (follow-up).
    Results: The smartphone app demonstrated high feasibility, with strong participant retention and compliance. The participants expressed high levels of satisfaction with the app's user-friendliness and content, highlighting its acceptability. Both groups showed a significant reduction in missed doses over time (
    Conclusion: Adherence-targeted notifications have the potential to be an effective and scalable approach to supporting medication adherence in patients with gout. Further research is needed with larger samples to refine the components of the intervention and explore its optimal implementation.
    MeSH term(s) Humans ; Smartphone ; Allopurinol/therapeutic use ; Feasibility Studies ; Uric Acid ; Gout ; Medication Adherence ; Mobile Applications
    Chemical Substances Allopurinol (63CZ7GJN5I) ; Uric Acid (268B43MJ25)
    Language English
    Publishing date 2024-02-01
    Publishing country Canada
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.2023-0711
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  9. Article ; Online: A Systematic Review of Patient-Reported Adherence Measures in Asthma: Which Questionnaire Is Most Useful in Clinical Practice?

    Quirke-McFarlane, Sophia / Weinman, John / d'Ancona, Gráinne

    The journal of allergy and clinical immunology. In practice

    2023  Volume 11, Issue 8, Page(s) 2493–2503

    Abstract: Background: Suboptimal adherence to inhaled corticosteroid in asthma is a worryingly prevalent yet modifiable factor in uncontrolled disease. Several objective measures of adherence exist, but they are time-consuming. The use of patient-reported ... ...

    Abstract Background: Suboptimal adherence to inhaled corticosteroid in asthma is a worryingly prevalent yet modifiable factor in uncontrolled disease. Several objective measures of adherence exist, but they are time-consuming. The use of patient-reported adherence measures (PRAMs) could therefore offer a time-efficient pragmatic approach to assessing adherence in clinical practice and potentially the appropriate interventions to improve it.
    Objectives: To identify the PRAMs available for asthma and assess their psychometric quality, accessibility, and usefulness in clinical practice, as well as to provide recommendations for clinicians based on these findings.
    Methods: We conducted a systematic review of six databases. Articles included in this study were English language, full-text, original, asthma-specific PRAMs or development/validation studies of a generic PRAM that had been administered to adults with asthma, investigated inhaled corticosteroid adherence in adults (aged 18 years and older), and assessed at least one COnsensus-based Standards for the selection of health Measurement INstruments measurement property.
    Results: We included 15 PRAM developmental and/or validation studies in this systematic review. Studies evaluated a range of COnsensus-based Standards for the selection of health Measurement INstruments measurement properties, but none evaluated all of them.
    Conclusions: Based on this review, we recommend that when a PRAM is used, it should be the Test of the Adherence to Inhalers. However, the Adherence Starts with Knowledge-20 and Adherence Starts with Knowledge-12 may also be useful. Our results highlight the need for PRAM developers to assess questionnaires robustly and provide guidance for clinicians regarding how to act on PRAM answers by developing materials such as decision support tool kits.
    MeSH term(s) Adult ; Humans ; Asthma/drug therapy ; Patient Compliance ; Surveys and Questionnaires ; Adrenal Cortex Hormones/therapeutic use ; Psychometrics ; Patient Reported Outcome Measures
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2023-03-29
    Publishing country United States
    Document type Systematic Review ; Journal Article
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2023.03.034
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  10. Article ; Online: Explaining all without causing unnecessary harm: Is there scope for positively framing medical risk information?

    Webster, R K / Weinman, J / Rubin, G J

    Patient education and counseling

    2018  Volume 102, Issue 3, Page(s) 602–603

    Abstract: Clinicians in the United Kingdom are now legally obliged to tell patients about every risk involved in prescribed medical treatments. Although important for informed consent, warning patients of risks such as side-effects can increase the incidence of ... ...

    Abstract Clinicians in the United Kingdom are now legally obliged to tell patients about every risk involved in prescribed medical treatments. Although important for informed consent, warning patients of risks such as side-effects can increase the incidence of these very side-effects, through the nocebo effect. Positively framing risk information could be a potential solution to this dilemma, and preliminary data has shown it is effective in healthy volunteers receiving a sham drug. Future research is needed to test its effectiveness in a clinical population.
    MeSH term(s) Consumer Health Information ; Disclosure/ethics ; Drug-Related Side Effects and Adverse Reactions ; Ethics, Medical ; Humans ; Informed Consent/psychology ; Nocebo Effect ; Physician-Patient Relations
    Language English
    Publishing date 2018-09-15
    Publishing country Ireland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605590-4
    ISSN 1873-5134 ; 0738-3991
    ISSN (online) 1873-5134
    ISSN 0738-3991
    DOI 10.1016/j.pec.2018.09.014
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