Jee-Won Park

Effects of a community‐based intervention on cardio‐metabolic risk and self‐care behaviour in older adults with metabolic syndrome

This pilot study was performed to investigate the effects of a community-based intervention (CBI) on cardio-metabolic risk and self-care behaviour in 92 older adults with metabolic syndrome at public health centres in Suwon, Korea. A prospective, pretest and posttest, controlled, quasi-experimental design was used. The older adults in the intervention group participated in an 8-week intensive lifestyle counselling, whereas those in the control group received usual care. The mean (standard deviation) age of the participants was 71.4 (4.43) years ranging from 60 to 84, and 75.0% of the participants were female. The intervention group at 8 weeks showed significant reduction in waist circumference by −1.35 cm (P < 0.001) and improved self-care behaviour (+ 5.17 score, P < 0.05) and self-efficacy (+ 4.84 score, P < 0.001) when compared with the control group. The percentages of those who successfully completed the targeted behavioural modification were 71.7% for exercise and 52.2% for dietary control in the intervention group at 8 weeks. This pilot study provided evidence of the beneficial impact of the CBI for Korean older adults with metabolic syndrome.This pilot study was performed to investigate the effects of a community-based intervention (CBI) on cardio-metabolic risk and self-care behaviour in 92 older adults with metabolic syndrome at public health centres in Suwon, Korea. A prospective, pretest and posttest, controlled, quasi-experimental design was used. The older adults in the intervention group participated in an 8-week intensive lifestyle counselling, whereas those in the control group received usual care. The mean (standard deviation) age of the participants was 71.4 (4.43) years ranging from 60 to 84, and 75.0% of the participants were female. The intervention group at 8 weeks showed significant reduction in waist circumference by -1.35 cm (P<0.001) and improved self-care behaviour (+5.17 score, P<0.05) and self-efficacy (+4.84 score, P<0.001) when compared with the control group. The percentages of those who successfully completed the targeted behavioural modification were 71.7% for exercise and 52.2% for dietary control in the intervention group at 8 weeks. This pilot study provided evidence of the beneficial impact of the CBI for Korean older adults with metabolic syndrome.

Evaluation of the Measurement Properties of Self-reported Medication Adherence Instruments Among People at Risk for Metabolic Syndrome A Systematic Review

Purpose The purpose of this study was to present a systematic review of available published studies that evaluated the measurement properties of self-reported instruments assessing global medication adherence in adults at risk for metabolic syndrome. Methods The authors searched PubMed, EMBASE, PsycINFO, and CINAHL in January 2015 for appropriate studies. The methodological quality (based on reliability, validity, responsiveness, and interpretability) of selected studies was assessed with the COSMIN checklist (Consensus-Based Standards for the Selection of Health Measurement Instruments). Results Of the 44 studies reviewed, 32 used classical test theory, and 14 used self-reported medication adherence instruments. More than half the studies included patients with hypertension, followed by diabetes, dyslipidemia, and increased body mass index. Among the measurement properties, internal consistency, hypothesis testing, and structural validity were frequently assessed items, whereas only 1 study evaluated responsiveness, and none evaluated measurement error. The MMAS-8 (Morisky Medication Adherence Scale–8 items) and the Hill-Bone scale were the most frequently used instruments. They were found to be well validated, with strong evidence for internal consistency and strong positive evidence for reliability, structural validity, hypothesis testing, and criterion validity. Conclusions The MMAS-8 and Hill-Bone scale seem to be well-validated instruments for assessing medication adherence in adults at risk for metabolic syndrome. These findings may assist clinicians with selecting the appropriate instruments for assessing medication adherence in this population. However, further studies might be needed to define concepts to better understand the dimensions of each medication adherence instrument.

Quality Evaluation of Randomized Controlled Trials on Complementary and Alternative Medicine

PURPOSE This study aims to describe the research characteristics and analyze the methodological quality of randomized clinical trials on complementary and alternative medicine (CAM). METHODS A total of 76 studies using randomized controlled trials (RCTs) on CAM (16 by Koreans, 60 by internationals) published in the 6 years from 2000 to 2005 were reviewed systematically and analyzed with assessment criteria developed by the researchers on the basis of Jadad guidelines. RESULTS Most of the studies were carried out in the area of medicine, nursing and CAM. More than 80% of the study subjects were patients. CAM modalities for independent variables were mainly on energy medicine, mind-body medicine and manipulative and body-based practices, while dependent variables were mostly physiological and psychological indexes. Most of the studies utilized randomization (93.4%) and identified the dropout rate (90.8%), whereas allocation concealment (49.3%) and double-blinding (18.9%) were specified in a small number of studies. The overall quality of RCTs based on the assessment criteria of this study was satisfactory. However, the quality score of the Korean studies (2.87) was lower than that of the international studies (3.37). CONCLUSION The methodological objectivity of CAM studies has been improving in spite of controversy over the scientific bases of CAM. More Korean studies with rigorous experimental design are needed to build up the evidence-based practice of CAM.