Evidence mapPaperPMID 38724060Full record

ArticleBMJ open2024

Evaluation of adherence to pharmacological treatments by undocumented migrants with chronic diseases: a 10-year retrospective cohort study.

Gianfrancesco Fiorini, Giacomo Pellegrini, Matteo Franchi, Antonello Emilio Rigamonti, Nicoletta Marazzi, Alessandro Sartorio, Giovanni Corrao, Silvano Gabriele Cella

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Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Gianfrancesco FioriniIstituti Clinici Zucchi Spa, Monza, Italy gfr.fiorini@gmail.com.ORCID 0000-0001-5468-4063
Giacomo PellegriniUniversità degli Studi di Milano-Bicocca, Milano, Italy.ORCID 0000-0001-6935-8332
Matteo FranchiUniversità degli Studi di Milano-Bicocca, Milano, Italy.
Antonello Emilio RigamontiUniversità degli Studi di Milano, Milano, Italy.
Nicoletta MarazziIstituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy.
Alessandro SartorioIstituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy.
Giovanni CorraoUniversità degli Studi di Milano-Bicocca, Milano, Italy.ORCID 0000-0002-1034-8444
Silvano Gabriele CellaUniversità degli Studi di Milano, Milano, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the time course of medication adherence and some of the factors involved in this process in undocumented migrants with chronic diseases.

designRetrospective cohort study.

settingA big non-governmental organisation in Milano, Italy, giving medical assistance to undocumented migrants.

participants1918 patients, 998 females and 920 males, with at least one chronic condition (diabetes, cardiovascular diseases (CVDs), mental health disorders) seen over a period of 10 years (2011-2020). Their mean age was 49.2±13 years.

resultsAdherence to medications decreased over 1 year in all patients. This was more evident during the first 2 months of treatment. Patients on only one medication were less adherent than those on more than one medication; at 6 months the percentage of patients with high adherence was 33% vs 57% (p<0.0001) for diabetes, 15% vs 46% (p<0.0001) for mental disorders and 35% vs 59% (p<0.0001) for CVDs. Patients with mental disorders had the lowest adherence: 25% at 6 months and 3% at 1 year. Mental disorders, when present as comorbidities, greatly reduced the probability of being highly adherent: risk ratio (RR) 0.72 (95% CI 0.57 to 0.91; p=0.006) at 3 months, RR 0.77, (95% CI 0.59 to 1.01; p=0.06) at 6 months, RR 0.35 (95% CI 0.13 to 0.94; p=0.04) at 1 year. This was especially evident for patients with CVDs, whose percentage of high adherents decreased to 30% (p=0.0008) at 6 months and to 3% (p=0.01) at 1 year. We also noted that highly adherent patients usually were those most frequently seen by a doctor.

conclusionsInterventions to increase medication adherence of undocumented migrants with chronic diseases are necessary, particularly in the first 2 months after beginning treatment. These should be aimed at people-centred care and include more outpatient consultations. Educational interventions should especially be taken into consideration for patients on monotherapy.

Indexed as

Drug MonitoringMental DisordersTransients and MigrantsAdultCardiovascular DiseasesChronic DiseaseDiabetes MellitusFemaleHumansItalyMaleMiddle AgedRetrospective Studiescardiovascular diseasediabetes & endocrinologymedication adherencemental health

Identifiers

PMID38724060
PMCPMC11086564

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.