***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective The goal of this study was to evaluate clinical ly the acceptability of the IDAS II ( Intelligent Drug Administration System ) , a new electronic device that enables drug adherence monitoring . Methods IDAS II was compared to another electronic monitor , the Medication Event Monitoring System ( MEMS ) in a r and omised two-way cross-over study involving 24 hypertensive patients treated with irbesartan .  Patients used each device for 2 months . The main parameter of evaluation was the patients ’ opinion on both devices . Rates of adherence and blood pressure were also assessed . Results Most patients considered both devices to be reliable reminders ( IDAS II : 75%;MEMS : 84 % , p = ns ) . Ten patients ( 42 % ) preferred the MEMS , while 11 ( 46 % ) preferred the IDAS II ; three ( 12 % ) expressed no preference . Patients found the MEMS device easier to use than the IDAS device ( p < 0.001 ) but appreciated the IDAS blister packs better than the MEMS bulk packaging ( p < 0.01 ) . Over the 4-month period , the median “ taking adherence ” was excellent ( 99.2 % ) and comparable with both devices . However , the regularity of drug intake timing was higher with the IDAS II ( p < 0.01 ) . Conclusion IDAS II , a new electronic device enabling drug adherence monitoring without reconditioning of the drugs appears to be a well-accepted device . Overall , practicability and acceptability of the IDAS II and the MEMS device were similar . Thus , IDAS II could be a useful tool for the management of long-term therapies OBJECTIVE To examine the extent to which district health teams could reduce the burden of malaria , a continuing major cause of mortality and morbidity , in a situation where severe re source constraints existed and integrated care was provided . METHODS Antimalarial drugs were prepackaged into unit doses in an attempt to improve compliance with full courses of chemotherapy . FINDINGS Compliance improved by approximately 20 % in both adults and children . There were 50 % reductions in cost to patients , waiting time at dispensaries and drug wastage at facilities . The intervention , which tended to improve both case and drug management at facilities , was well accepted by health staff and did not involve them in additional working time . CONCLUSION The prepackaging of antimalarials at the district level offers the prospect of improved compliance and a reduction in the spread of resistance Outpatient medication adherence is a major problem , especially for patients repeatedly hospitalized for psychiatric disorders . This study included 39 such patients who were receiving case management services from a community mental health center . Patients were matched and r and omly assigned to receive in a single session either ( 1 ) information regarding medication and its benefits , ( 2 ) guidelines for assuring adherence which encompassed all phases related to pill-taking including filling prescriptions , use of a pill container , transportation , self-reminders , doctor 's appointments and so forth , or ( 3 ) the same guidelines as ( 2 ) above but given in the presence of a family member who was enlisted in support . The results showed that adherence increased to about 94 % after the guidelines were given for both the individual and family guideline procedure , whereas adherence remained unchanged at 73 % after the medication information procedure . These results suggest a practical means for assuring a high level of medication adherence for patients with psychiatric disorders We investigated the impact of pre-packaging antimalarial drugs and counselling on compliance with treatment of malaria at the Adult Outpatient Department of Port Moresby General Hospital . Adult patients who were prescribed st and ard antimalarial drugs following clinical and microscopic diagnosis of malaria were r and omly assigned to one of three groups : an intervention group , where pre-packaging and counselling instructions were applied ; control group A , with counselling but no pre-packaging ; and control group B , with neither counselling nor pre-packaging . Patients were interviewed on two occasions , day 1 of treatment and day 4 post treatment . Of a total of 436 patients , 322 patients ( 179 males and 143 females ) completed the study . Our data indicate an increase of 18 % in compliance with treatment in the intervention group and 16 % in control group A , when compared with control group B. While compliance with treatment was gender independent , the language spoken and used for giving instructions and counselling may have influenced patients ' behaviour on prescribed medication . The results of our study indicate that a simple pre-packaging system and proper counselling could improve compliance with antimalarial drug treatment . As an additional beneficial observation , pre-packaging is likely to eliminate errors and possible contamination of the products during dispensing Abstract Objective To determine whether home based medication review by pharmacists affects hospital readmission rates  among older people . Design R and omised controlled trial . Setting Home based medication review after discharge from acute or community hospitals in Norfolk and Suffolk . Participants 872 patients aged over 80 recruited during an emergency admission ( any cause ) if returning to own home or warden controlled accommodation and taking two or more drugs daily on discharge . Intervention Two home visits by a pharmacist within two weeks and eight weeks of discharge to educate patients and carers about their drugs , remove out of date drugs , inform general practitioners of drug reactions or interactions , and inform the local pharmacist if a compliance aid is needed . Control arm received usual care . Main outcome measure Total emergency readmissions to hospital at six months . Secondary outcomes included death and quality of life measured with the EQ-5D . Results By six months 178 readmissions had occurred in the control group and 234 in the intervention group ( rate ratio = 1.30 , 95 % confidence interval 1.07 to 1.58 ; P = 0.009 , Poisson model ) . 49 deaths occurred in the intervention group compared with 63 in the control group ( hazard ratio = 0.75 , 0.52 to 1.10 ; P = 0.14 ) . EQ-5D scores decreased ( worsened ) by a mean of 0.14 in the control group and 0.13 in the intervention group ( difference = 0.01 , -0.05 to 0.06 ; P = 0.84 , t test ) . Conclusions The intervention was associated with a significantly higher rate of hospital admissions and did not significantly improve quality of life or reduce deaths . Further research is needed to explain this counterintuitive finding and to identify more effective methods of medication review BACKGROUND type 2 diabetes mellitus continues to increase in prevalence worldwide . Many factors have been cited as contributing to compliance , such as family and social support , education , number of tablets per dose , frequency of administration and health care provider communication . Toward these goals , the present study was developed to measure the effect offactors on glycemic control such as diabetes education by pharmacists , a diabetes disease booklet and special medication containers . MATERIAL AND METHOD A total of 360 volunteers with type 2 DM patients were recruited , participants were simple r and omized to control 180 and intervention 180 patients . Which intervention categorized to 4 groups ; all intervention groups received diabetes drug counseling by a pharmacist , one group received plus a diabetes booklet , one received plus special medical containers and the last group received all of them . The interventions were done at the 1st time of visit . Both the control and intervention groups were monitored for fasting plasma glucose and HbA1c at 0 , 3 , 6 months and glycemic level in both groups was compared . RESULTS After 3 months , mean fasting plasma glucose and HbA1c decreased wiih the intervention group vs. control group ( 152.36 + /- 39.73 to 131.52 + /- 35.22 mg% ) and ( 150.16 + /- 41.78 to 153.98 + /- 47.95 mg% ) respectively ; ( p < 0.001 ) . HbA1c level 8.16 + /- 1.44 to 7.72 + /- 1.26 vs 8.01 + /- 1.51 to 8.38 + /- 1.46 respectively ; ( p < 0.001 ) . After 6 months , mean fasting plasma glucose and HbA1c decreased with the intervention group vs. control group ( 152.36 + /- 39.73 to 145.20 + /- 46.07 mg% ) and ( 150.16 + /- 41.78 to 159.16 + /- 54.90 mg% ) respectively ; ( p < 0.013 ) . HbA1c level 8.16 + /- 1.44 to 7.91 + /- 1.27 vs. 8.01 + /- 1.51 to 8.80 + /- 1.36 respectively ; ( p < 0.001 ) . The most favorable glycemic outcome was the group that received all of the interventions ; mean FPG was reduced from 147.46 + /- 36.07 to 125.38 + /- 31.12 mg% ( p < 0.000 ) in 1nd visit ( 3 months later ) and still reducing effect on the 2nd visit ( 6 month later ) mean FPG from 147.46 + /- 36.07 to 130.21 + /- 33.96 mg% ( p < 0.016 ) also the same way in HbA 1c level . The group that received only drug counseling by pharmacist had no significant reduction in FPG and HbA1c . ( p > 0.05 ) . CONCLUSION Drug counseling by a pharmacist has little beneficial effect on diabetes management outcome compared to the diabetes booklet and special drug container . To improve glycemic control of type 2 DM is to integrate self-management in daily life , wide a variety of education , drug taken behavior and health care provider available communication produce improvement in patient management and is somewhat better when used in combination CONTEXT Rising costs of medications and inequities in access have sparked calls for drug policy reform in the United States and Canada . Control of drug expenditures by prescription cost-sharing for elderly persons and poor persons is a contentious issue because little is known about the health impact in these subgroups . OBJECTIVES To determine ( 1 ) the impact of introducing prescription drug cost-sharing on use of essential and less essential drugs among elderly persons and welfare recipients and ( 2 ) rates of emergency department ( ED ) visits and serious adverse events associated with reductions in drug use before and after policy implementation . DESIGN AND SETTING Interrupted time-series analysis of data from 32 months before and 17 months after introduction of a prescription coinsurance and deductible cost-sharing policy in Quebec in 1996 . Separate 10-month prepolicy control and postpolicy cohort studies were conducted to estimate the impact of the drug reform on adverse events . PARTICIPANTS A r and om sample of 93 950 elderly persons and 55 333 adult welfare medication recipients . MAIN OUTCOME MEASURES Mean daily number of essential and less essential drugs used per month , ED visits , and serious adverse events ( hospitalization , nursing home admission , and mortality ) before and after policy introduction . RESULTS After cost-sharing was introduced , use of essential drugs decreased by 9.12 % ( 95 % confidence interval [ CI ] , 8.7%-9.6 % ) in elderly persons and by 14.42 % ( 95 % CI , 13.3%-15.6 % ) in welfare recipients ; use of less essential drugs decreased by 15.14 % ( 95 % CI , 14.4%-15.9 % ) and 22.39 % ( 95 % CI , 20.9%-23.9 % ) , respectively . The rate ( per 10 000 person-months ) of serious adverse events associated with reductions in use of essential drugs increased from 5.8 in the prepolicy control cohort to 12.6 in the postpolicy cohort in elderly persons ( a net increase of 6.8 [ 95 % CI , 5.6 - 8.0 ] ) and from 14.7 to 27.6 in welfare recipients ( a net increase of 12.9 [ 95 % CI , 10.2 - 15.5 ] ) . Emergency department visit rates related to reductions in the use of essential drugs also increased by 14.2 ( 95 % CI , 8.5 - 19.9 ) per 10 000 person-months in elderly persons ( prepolicy control cohort , 32.9 ; postpolicy cohort , 47.1 ) and by 54.2 ( 95 % CI , 33.5 - 74.8 ) among welfare recipients ( prepolicy control cohort , 69.6 ; postpolicy cohort , 123.8 ) . These increases were primarily due to an increase in the proportion of recipients who reduced their use of essential drugs . Reductions in the use of less essential drugs were not associated with an increase in risk of adverse events or ED visits . CONCLUSIONS In our study , increased cost-sharing for prescription drugs in elderly persons and welfare recipients was followed by reductions in use of essential drugs and a higher rate of serious adverse events and ED visits associated with these reductions OBJECTIVE To examine the relationship between adherence to a medical regimen and mortality following a myocardial infa rct ion in women . DESIGN Analysis of the female cohort entered into a r and omized double-blind multicenter trial . SETTING National Heart , Lung , and Blood Institute 
    Output:
    
Reminder packing may represent a simple method for improving adherence for patients with selected conditions .