Introduction: Hypertension and its complications are massive global health issues. Major limitations in hypertensive patients’ treatment include suboptimal blood pressure control and nonadherence to medication. The popularity of telemedicine has risen in recent years. Mobile phone applications intervention in particular, provides features including medication-taking, refilling reminders, and biometric results tracker resulting in better health outcomes and improved medication adherence. This review aims to assess the effectiveness of mobile application in improving adherence in hypertensive patients. Methods: PubMed, Scopus, and Cochrane Library were searched with filters applied for studies published between 2013 and 2023 and content published in English with the keywords; telemedicine, mobile apps, medication adherence, and hypertension. These keywords were joined using Boolean operators for an effective search. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement was followed for this systematic review. The Mixed Method Appraisal Tool was used to assess the quality of the included studies. The data was extracted by the authors and validated by another for accuracy and completeness. Results: Twelve studies ranging from moderate to high quality were included in this review. A total of 10 studies showed a statistically significant improvement (p < 0.001) in medication adherence with mobile apps intervention. The combined apps features from the mobile apps empower patients to be more adherent, involved and informed about their treatment progress. Conclusion: Hypertensive patients’ medication adherence improved with mobile apps intervention. However, the heterogeneity of adherence measurement methods and apps functionality in the included studies calls for further studies to determine the effectiveness of specific mobile apps feature as well as the standardisation of the adherence measurement method used.

Objectives: This study examined the adherence to opioid therapy in patients with chronic noncancer pain (CNCP). The prevalence of opioid use and pain scores was also explored. Methods: This cross-sectional study was conducted among patients with noncancer pain attending a pain clinic at a tertiary hospital in Malaysia from August 2016 to February 2017. All patients prescribed with any of the five available opioids (morphine, oxycodone, fentanyl, buprenorphine, and dihydrocodeine) were included in the study, and their medical and prescription records were assessed for further information on opioid use such as the type of opioid, dose, frequency, and duration. The prevalence of opioid use was calculated by dividing the number of opioid users and the total number of patients attending the pain clinic during the study. Adherence was calculated for patients with long-term opioid therapy (>90 days/ year) and measured using the medication possession ratio (MPR). This was derived by sum up the total days covered with medication in the last 365 days; and then divide that by the total days, the medication was prescribed over the same period. A cutoff point of 80% or more was considered as adherence. The pain intensity score was assessed through a numerical scale from 0 (no pain) to 10 (worst possible pain) at four different points (now, on average, least in the last 24 h, and worst in the last 24 h). Results: A total of 555 patients with various noncancer pain conditions attended the pain clinic during the study. The prevalence of opioid use among these patients was 13.5% (n=74/555). Of these, 24.3% (n=18/74) of patients using opioids for long term (>90 days) and were included in the adherence measure. 78% (n=14/18) of these long-term opioid users were adherent to opioid therapy with a reported MPR >80%. 22% (n=4/18) of patients showed nonadherence to opioid therapy with a reported MPR <80%. The mean pain score for both adherent and nonadherent groups was 5/10, and there was no statistical difference between the two groups. Conclusion: The preliminary results of this study demonstrated that the majority of patients with chronic opioid use adhered to their prescribed opioids. The prevalence of opioid use among patients with noncancer pain was low, and the number of patients using opioid for the long term was ~20% which is similar to the finding from the previous study. The future research is required to evaluate the clinical outcomes in patients with CNCP using opioid for long term particularly in nonadherent patients.

Pistacia species (P. spp) have been used as a treatment for various diseases, including diabetes and inflammation. This study aimed to identify the main components of flavonoids in Pistacia species and evaluate the effect of aqueous extracts of P. spp on pancreatic enzymes and on cancer cells associated with obesity in colon and rectum. HPLC was used to identify the major components of flavonoids. The potent inhibitory effect of Pistacia species against pancreatic α-amylase, α-glucosidase and lipase was examined. The antiproliferative efficacy of the plant extract against several colorectal cancer cell lines were then measured. The main flavonoids component found in Pistacia species are quercetin-3-β-D-glucoside, rutin, kaempferol and vitexin. The starch blockade IC₅₀ (µg/mL) of Pistacia species in a descending order were: P. lentiscus leaves: 1.09±0.01; P. atlantica leaves: 0.96±0.09 and P. atlantica fruits: 0.48±0.02. Pistacia species exerted promising inhibition effect for pancreatic lipase (PL). Besides the aglycones of P. atlantica leaves, all the tested aqueous extracts exerted appreciably novel antiproliferative activity against the tested colorectal cancer cell lines. This study provides useful indication for the Pistacia species as a potential novel therapeutic agent against diabesity and cancer.

Adherence towards antidepressant agents is a vital element in effectively managing depression. Non-adherence of antidepressants can lead to a recurrence of depressive symptoms and decreased treatment effectiveness. Adherence is assessed using various types of measures. This study aims to evaluate the different methods used to assess the adherence towards antidepressants on adults with depression. This systematic review adhered to the guidelines outlined in the PRISMA statement. PubMed, Cochrane Library, and Scopus are searching from 2013 to 2023 for articles that studied or reported on antidepressant adherence measures in adults with depression. Two authors conducted independent screenings of the articles against the eligibility criteria, examining titles, abstracts, and full-texts. The risk of bias for all included studies were assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Information from all the selected articles was extracted using a predefined table. 15 studies met the eligibility criteria. When measuring adherence towards antidepressant at initiation and/or implementation phase, self-report methods such as Medication Adherence Rating Scale (MARS) demonstrated acceptable reliability and validity, while Brief Medication Questionnaire (BMQ by Svarstad et al.), Morisky Medication Adherence Questionnaire (MAQ), and Brief Adherence Rating Scale (BARS) showed good validity, and Morisky Medication Adherence Scale (MMAS), Morisky Green Levine Adherence (MGLA), Beliefs about Medicine Questionnaire (BMQ by Horne et al.) and Drug Attitude Inventory (DAI-10) showed good reliability. This study found a diverse range of methods to measure adherence towards antidepressant in adults. Self-report assessments, particularly in primary care and psychiatric settings, emerged as the most practical tools followed by clinician-rating scale, pharmacy refill data, adherence scale, pill count, and average serum level. No single measure with consistently shown strong reliability and validity across different adherence stages, highlighting the need for a combined approach.