BACKGROUND: Postoperative nausea and vomiting (PONV) in pediatric patients is a common and clinically significant postoperative complication. The incidence of PONV has not been extensively studied in large pediatric cohorts. Furthermore, in 2020, the Fourth Consensus Guidelines for the management of PONV were published. However, the association between perioperative factors and adherence to these guidelines remains unclear. This study aims to assess both the incidence of PONV and guideline adherence within a large and diverse pediatric population. METHODS: We conducted a retrospective observational study at a large tertiary medical center, including pediatric patients (≤18 years) who underwent surgery between September 2020 and March 2023. We conducted a retrospective analysis of data from our electronic health records, focusing on patient demographics, surgical details, anesthesia details, and prophylaxis for PONV. We calculated the incidence of PONV and used multivariable logistic regression to identify the predictors of guideline adherence. RESULTS: The cohort included 3772 patients with a median (interquartile range [IQR]) age of 9.21 (3.55-14.68) years. The incidence (95% confidence intervals) of early PONV was 1.0% (0.7-1.4) and 3.8% (3.2-4.5) for delayed PONV. Adherence to the fourth consensus guidelines for PONV management was observed in 32.5% (31.0-34.0) of cases. A high risk of PONV was identified in 55.9% (54.3-57.5) of the patients. The most common number of PONV risk factors was 3, observed in 1151 patients (30.5% [29.1-32.0]). Significant predictors of guideline adherence included the intraoperative use of long-acting opioids (odds ratio [OR], 2.711, P < .001) and age ≥3 years (OR, 2.074, P < .001). Nonadherence was associated with a higher incidence of PONV at 24 hours postsurgery (4.4% (3.6-5.2) vs 2.7% (1.9-3.8), P = .012). Factors such as specific high PONV risk surgeries ( P = .001), maintenance with inhalational agents solely ( P = .017), and neostigmine use ( P < .001) were also all statistically significant. CONCLUSIONS: Our study revealed a lower-than-expected incidence of PONV in pediatric patients, highlighting the need for standardized definitions and improved reporting. Adherence to PONV guidelines was suboptimal, emphasizing the need for better implementation strategies.

• MeSH
• antiemetika terapeutické užití   MeSH
• dítě MeSH
• dodržování směrnic * normy   MeSH
• incidence MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• pooperační nevolnost a zvracení * epidemiologie   diagnóza   prevence a kontrola   MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• směrnice pro lékařskou praxi jako téma normy   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

Promoting healthy aging through physical activity (PA) is crucial as the global population grows older. Traditional interventions often fail to engage older adults, underlining the need for personalized, timely approaches. Smartphone-delivered PA interventions can offer personalized support during opportune moments for behavioral change. The current study examined whether the receptivity of inactive older adults influences compliance with mHealth walking suggestions after inactivity, and explored their experiences with it. Thirty healthy older adults (mean age 73.9 years) participated in the study and answered event-based EMA questionnaires via HealthReact after each 30-minute inactivity period. Emotions, physical complaints, intention, self-efficacy, perceived walking, and environmental permissiveness were assessed. Walking suggestions followed each EMA, and semi-structured interviews were conducted post-study. Multilevel logistic regressions in R were applied, and qualitative data were thematically analyzed using NVivo. Results show that higher intention, self-efficacy, and environmental permissiveness positively correlated with compliance, while higher perceived walking negatively correlated. Participants generally found the suggestions motivating and well-timed, but some reported increased alertness and pressure. Consequently, tailoring interventions to individual needs and targeting receptive moments can enhance compliance and promote healthier aging through increased PA. Future mobile interventions should consider self-efficacy, intention, prior activity, and environmental conditions to improve effectiveness.

• MeSH
• adherence pacienta * psychologie   MeSH
• chůze * psychologie   MeSH
• chytrý telefon MeSH
• cvičení psychologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• podpora zdraví * metody   MeSH
• sebeuplatnění MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• telemedicína MeSH
• úmysl MeSH
• zdravé stárnutí * psychologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Rationale: Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. Objectives: To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. Methods: A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives (QIIs) in hospitals. Measurements and Main Results: A total of 1,023 hospitals in 69 countries were included. Most of them, 835 (81.6%), were in Europe. Sepsis screening was used in 54.2% of emergency departments (EDs), 47.9% of wards, and 61.7% of ICUs. Sepsis management was standardized in 57.3% of EDs, 45.2% of wards, and 70.7% of ICUs. The implementation of comprehensive QIIs was associated with increased screening (EDs, +33.3%; wards, +44.4%; ICUs, +23.8% absolute difference) and increased standardized sepsis management (EDs, +33.6%; wards, +40.0%; ICUs, +17.7% absolute difference) compared with hospitals without QIIs. A total of 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. Conclusions: The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regard to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.

• MeSH
• antibiotická politika MeSH
• dodržování směrnic * statistika a číselné údaje   MeSH
• jednotky intenzivní péče normy   MeSH
• lidé MeSH
• nemocnice * normy   statistika a číselné údaje   MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• sepse * terapie   diagnóza   MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• urgentní služby nemocnice normy   MeSH
• zlepšení kvality * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

• MeSH
• adherence k farmakoterapii MeSH
• kardiovaskulární nemoci * farmakoterapie   MeSH
• kombinovaná farmakoterapie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• rizikové faktory kardiovaskulárních chorob * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

• MeSH
• adherence pacienta MeSH
• kulturní charakteristiky MeSH
• kulturní různorodost MeSH
• průzkumy a dotazníky MeSH
• Romové MeSH
• služby domácí péče MeSH
• transkulturní ošetřovatelství MeSH
• zdravotní gramotnost MeSH

BACKGROUND: Dyslipidaemia is a key risk factor for atherosclerotic cardiovascular disease (ASCVD), necessitating effective statin therapy. Despite statins' proven safety and efficacy, adherence remains suboptimal, with significant gaps between clinical practice and guideline recommendations. METHODS: This retrospective cohort study analysed anonymized health administrative claims data from six employee health funds in the Czech Republic, covering approximately 40% of the insured population from January 1, 2017, to December 31, 2020. We identified statin-incident as well as prevalent cohort of patients. Adherence to statin therapy was assessed using the proportion of days covered (PDC) metric, with factors such as age, gender, sequence of use, and treatment intensity considered as modifiers. RESULTS: Among the statin-prevalent cohort (SP, n = 890,180), 83.5% achieved a PDC ≥ 50%, and 61.0% reached a PDC ≥ 80%. In the statin-incident cohort (SI, n = 287,871), a clear trend of increasing adherence with age and medication sequence was observed: in adults aged 18-39 median PDC rose from 84.1% (IQR: 57-100) in the first to 94.7% (IQR: 75.6-100) in the third sequence; in those aged 80 + median PDC rose from 95.0% (IQR: 68.9-100) in the first to 100% (IQR: 78.3-100) in the third sequence. Logistic regression identified age (OR=1.011 per year), female gender (OR=0.896), high-intensity treatment (OR=0.975), and second (OR=1.267) or later treatment sequences (OR=1.704) as significant predictors of adherence (all p < 0.001). CONCLUSION: Adherence to statin therapy improves with subsequent treatment sequences and age. These findings highlight the need for targeted interventions to enhance adherence, particularly among younger patients. The PDC metric is recommended for integration into clinical practice to monitor and improve medication adherence.

• MeSH
• adherence k farmakoterapii * MeSH
• dospělí MeSH
• dyslipidemie * farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• retrospektivní studie MeSH
• senioři MeSH
• statiny * terapeutické užití   MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• Klíčová slova
• gimifikace,
• MeSH
• adherence a compliance při léčbě MeSH
• adherence pacienta MeSH
• mobilní aplikace MeSH
• motivace MeSH
• role ošetřovatelky MeSH
• zdravotní sestry MeSH

AIMS: To assess perceptions, motivations and barriers to treatment adherence depending on emotional, lifestyle, medical and non-adherence risk profiles in hypertensive patients. METHODS AND RESULTS: Cross-sectional data were obtained using an online anonymous survey. Four distinct global risk scores (medical, lifestyle, emotional and quality of life (QoL) and non-adherence risk scores) were calculated based on the responses to specific groups of questions. A total of 2615 treated hypertensive patients (≥18 years of age) from 5 European countries completed the questionnaire. Mean (SD) age was 69.6 years (5.8); 54% males. Overall, antihypertensive therapy represented a low burden in patients' daily life (2.9/10 in the Likert scale). Perfect self-reported adherence was claimed by 59.8% of participants. Reporting of non-adherence episodes to physicians was low (13% always/often). Participants with a high non-adherence risk score had a greater number of associated diseases (obesity, sleep disturbances, depression and cardiac complications), a higher treatment-associated burden on daily life, a greater stress level and more antihypertensive pills per day (p < 0.001 for all). No correlation was found between the clinical and lifestyle risk scores and the risk of non-adherence. The emotional score correlated significantly with the non-adherence risk score (p < 0.001). Comparing patients with a low/middle risk to those with a high risk of non-adherence, female gender and age >65 years were associated with a lower odd ratio of non-adherence whereas depression, stress, family hardships, negative information on drugs and poor information were associated with higher odds of non-adherence. CONCLUSIONS: This large survey reveals several underestimated issues regarding patients' perspective in hypertension. It highlights the impact of emotions, exposure to family hardships, and stress on the risk of non-adherence. Non-adherence is underreported by patients; hence it remains mostly unrecognised.

• MeSH
• adherence k farmakoterapii * psychologie   MeSH
• antihypertenziva * terapeutické užití   MeSH
• hypertenze * farmakoterapie   psychologie   epidemiologie   MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• motivace * MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• životní styl MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: Schizophrenia is a serious mental illness, the pharmacological treatment of which comprises primarily the use of antipsychotics. However, non-adherence to their use and its reliable determination present a serious clinical and economic problem. This study aimed to determine therapeutic adherence in outpatients with schizophrenia spectrum disorders by combining short-term electronic monitoring of dispenser opening with the measurement of antipsychotic blood concentrations. METHODS: A total of 55 patients underwent a week-long electronic monitoring of dispenser opening and measurement of blood concentrations before and after monitoring. Patients who correctly opened the dispenser at least in 80% of scheduled time points during the weekly interval and, at the same time, did not show a change in blood concentration of the antipsychotic by more than 30% in any direction, were considered adherent. RESULTS: 69.1% of the patients met the adherence criteria, which was less than that determined by the Drug Attitude Inventory (DAI-10), the Visual Analogue Scale (VAS), and the Clinician Rating Scale (CRS). 7.3% of the patients took less than 80% of the prescribed doses and a change in blood concentrations of the antipsychotic by more than 30% was detected in 25.4% of the patients. In 70.9% of patients, the detected concentrations were within the recommended therapeutic reference interval. The groups of adherent and non-adherent patients did not differ statistically significantly in the severity of their illness as determined by the Clinical Global Impression (CGI), the Personal and Social Performance scale (PSP), and the Positive and Negative Syndrome Scale (PANSS). CONCLUSIONS: The combined method of evaluating adherence in schizophrenia patients confirmed the results determined by other methods. The benefits of this approach are described in the paper.

• MeSH
• adherence k farmakoterapii * psychologie   MeSH
• antipsychotika * krev   terapeutické užití   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• monitorování léčiv * metody   MeSH
• prospektivní studie MeSH
• schizofrenie * farmakoterapie   krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: The aim of the study was the assessment of adherence to antiretroviral (ARV) treatment in a population of people living with HIV (PWH), improving the awareness of PWH, drawing attention to the risk of developing HIV drug resistance and subsequent treatment failure. METHODS: The basic cohort consisted of PWH followed up long-term at the HIV centre of the University Hospital Pilsen. Adherence to treatment was assessed by ARV levels. Nucleoside analogs were determined in urine by high pressure liquid chromatography (HPLC), in relation to clinical data, viral load (HIV RNA), and absolute CD4 and CD8 T cell counts. To assess mental and physical state of the patients, a modified SF-36 questionnaire was used to measure social relationships, education and ability to relax. RESULTS: From a group of 131 PWH, 18 (13.7%) with zero levels and 113 (86.3%) with any detectable ARV levels were followed for 6-12 months. A statistically significant lower viral load was demonstrated in patients who adhered to the treatment at the time of the test as indicated by ARV levels in the urine. CD4 T lymphocyte values in adherent patients were, as expected, statistically significantly higher. A significant difference for CD8 T lymphocyte was not demonstrated. A survey assessed subjective factors influencing the degree of adherence. PWH consider important: quality care enabling trust, low risk of developing opportunistic infections, self-sufficiency, quality of sleep, managing leisure activities, and good family relationships. Quality of life evaluation and satisfaction in the monitored areas were similar in both groups of PWH. CONCLUSIONS: Non-adherence leads to deterioration of CD4 and viral load levels and may be the cause of the development of HIV drug resistance and treatment failure on the part of the patient. PWH with zero or low urinary nucleoside levels were repeatedly instructed about the need for regular and sustained medication use. Regular checks with a laboratory examination service are needed to detect early emergence of resistance and side effects of the treatment, which are initially only detectable in the laboratory.

• MeSH
• adherence k farmakoterapii * psychologie   MeSH
• dospělí MeSH
• HIV infekce * farmakoterapie   psychologie   MeSH
• kohortové studie MeSH
• kvalita života * MeSH
• látky proti HIV * terapeutické užití   moč   MeSH
• lidé středního věku MeSH
• lidé MeSH
• počet CD4 lymfocytů MeSH
• virová nálož MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH