Association between non-adherence behaviors, patients’ experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions

Abstract

Objective: The objective of the current work was to assess the frequency of non-adherence behaviors and potential association with patients' experience with healthcare and beliefs in medicines selfreported by patients with four different chronic conditions. Methods: Patients responded anonymously to a survey comprising five non-adherence behaviors (based on physician and patient input), an assessment of patients' experience with healthcare using the validated Instrument to Evaluate the EXperience of PAtients with Chronic diseases (IEXPAC), and a validated Spanish version of the Beliefs about Medicines Questionnaire (BMQ). Associations of nonadherence behavior were analyzed using logistic regression models. Results: Of 1530 respondents, 53.1% reported !1 non-adherence behavior. Non-adherence rates were 59.8% in diabetes mellitus (DM), 56.0% in rheumatic disease, 55.6% in inflammatory bowel disease, and 42.8% in human immunodeficiency virus (HIV) infection patients (p < .001). IEXPAC and BMQ scores were higher in adherent vs. non-adherent patients. In multivariate analysis, non-adherence behavior was strongly associated with lower overall BMQ, lower BMQ Necessity scores and higher BMQ Concerns scores (p < .001 for all), and with a lower IEXPAC self-management score (p ¼ .007), but not with the overall IEXPAC score. Non-adherence was more frequent in DM patients compared with HIV infection patients (p < .001). Conclusions: Patients' beliefs in medicines-a lower perception for the necessity of medication, and higher concerns in taking medication-and low patient self-management experience score were associated with non-adherence behavior. These are modifiable aspects that need to be addressed to increase medication adherence in chronic disease.

Is it me? The impact of patient–physician interactions on lupus patients’ psychological well-being, cognition and health-care-seeking behaviour

“…A more in-depth understanding of patients’ beliefs and behaviours based on their past experiences is important because they can be modified by clinicians using a patient-centred approach [ 15 ]. Greater understanding of patient experiences may also assist clinicians adapt their own behaviour to improve the medical relationship.…”

The Consequences of General Medication Beliefs Measured by the Beliefs about Medicine Questionnaire on Medication Adherence: A Systematic Review

“…The number of patients with chronic conditions is increasing dramatically and the real challenge is not only to identify non-adherent patients, but to prevent non-adherence behaviors to achieve better outcomes [ 46 ]. Patients’ initial decisions to not take medications might be influenced primarily by their general beliefs about medicine and consequently this will exacerbate concerns about the likely risk and the possible side effects of medications.…”

<p>Different Associations of Intentional and Non-Intentional Non-Adherence Behaviors with Patient Experience with Healthcare and Patient Beliefs in Medications: A Survey of Patients with Chronic Conditions</p>

“…The current work is a post hoc analysis of a previous cross-sectional study, in the form of an anonymous survey handed by clinical teams to 2474 patients with DM, HIV infection, IBD or rheumatic diseases. 16,17 Investigators invited consecutive patients from their clinics who fulfilled the following criteria: 1) adults (aged ≥18 years); 2) at least one of the following diagnoses: DM, HIV infection, IBD, or inflammatory rheumatic diseases; 3) regular follow-up by at least two different clinics or healthcare support entities (hospital specialists, primary care physicians, occupational therapist, social workers or others) and 4) able to understand and respond to the survey. Patients who, in the opinion of the treating physicians, were not able to understand/respond to the survey properly, or who had limiting diseases (cognitive impairment, major depression, end-stage disease), were not invited to participate.…”

“…Information on the development of the survey and the results in respect of patient experience and overall nonadherence behaviors has been described previously. 16,17 In summary, the survey content was developed by physicians with experience in the care of patients with the relevant conditions, taking into consideration input provided by patients from the respective patients' associations. The study was reviewed by the Clinical Research Ethics Committee of the Gregorio Marañón Hospital, Madrid, Spain.…”

“…15 Previously, we have described that non-adherence behaviors in patients are associated with their experience with healthcare and, especially, with their belief in medications in a large cohort of 1530 patients with diabetes mellitus [DM], human immunodeficiency virus [HIV] infection, inflammatory bowel disease [IBD], or rheumatic diseases. 16 Because the HIV population showed the lowest frequency of non-adherence, and this was due to a lower frequency of behaviors considered as intentional, and because effective measures to prevent non-adherence may be different, we considered it of interest to assess further associations between non-adherence behaviors deemed intentional or non-intentional with the background disease and with other variables, mainly patient experience with healthcare and their beliefs in medications through a post hoc analysis of the same population, which is the objective of the current work.…”