Beliefs about medicines and non-adherence in patients with stroke, diabetes mellitus and rheumatoid arthritis: a cross-sectional study in China

Abstract

ObjectivesTo investigate beliefs about medicines and their association with medicine adherence in patients with chronic diseases in China.DesignA cross-sectional questionnaire-based studySettingTwo large urban hospitals in Hefei and Tianjin, ChinaParticipantsHospital inpatients (313 stroke patients) and outpatients (315 diabetic patients and 339 rheumatoid arthritis (RA) patients) were recruited between January 2014 and September 2014.Outcome measuresThe Beliefs about Medicines Questionnaire (BMQ), assessing patients’ beliefs about the specific medicine (Specific-Necessity and Specific-Concerns) prescribed for their conditions (stroke/diabetes/RA) and more general background beliefs about pharmaceuticals as a class of treatment (BMQ-General Benefit, Harm and Overuse); the Perceived Sensitivity to Medicines scale (PSM) assessed patients’ beliefs about how sensitive they were to the effects of medicines and the Medication Adherence Report Scale. The association between non-adherence and beliefs about medicines was assessed using a logistic regression model.ResultsPatients with diabetes mellitus had a stronger perceived need for treatment (mean (SD) Specific-Necessity score, 3.75 (0.40)) than patients with stroke (3.69 (0.53)) and RA (3.66 (0.44)) (p=0.049). Moderate correlations were observed between Specific-Concerns and General-Overuse, General-Harm and PSM (Pearson correlation coefficients, 0.39, 0.49 and 0.49, respectively, p<0.01). Three hundred and eleven patients were non-adherent to their medicine (159 (51.0%) in the stroke group, 60 (26.7%) in the diabetes mellitus group and 62 (19.8%) in the RA group, p<0.01). Across the whole sample, after adjusting for demographic characteristics, non-adherence was associated with patients who had higher concerns about their medicines (OR, 1.35, 95% CI 1.07 to 1.71) and patients who believed that they were personally sensitive to the effects of medications (OR 1.44, 95% CI 1.16 to 1.85).ConclusionThe BMQ is a useful tool to identify patients at risk of non-adherence. In the future, adherence intervention studies may use the BMQ to screen for patients who are at risk of non-adherence and to map interventional support.

<p>Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study</p>

“…Recently, many studies have used nomograms in medicine and oncology because nomograms have the benefits of user-friendly interfaces, better accuracy and more easily understood results. 28 An innovative prediction tool for the incidence risk of DN or DR among T2DM patients was developed with only seven easily available variables. A prediction app was developed using R language with the shiny package; the URL is https://doctorhu.shinyapps.io/DN_DR_ DynNomapp/.…”

“…Internal validation in the cohort displayed moderate-good distinction and validation capabilities; particularly, our moderate C-index in the internal verification showed that this nomogram can be correctly used in a wide range of individuals due to the considerable sample size. 28 As an example to better explain the nomogram, if the T2DM patient's disease course was 9 years, BMI was 23.60 kg/m 2 , TGs were 1.14 mmol/l, SBP was 170 mmHg, PBG was 15.7 mmol/l, HbA1c was 8%, and BUN was 4.46 mmol/l, the probability of DN or DR was estimated to be 28.3% (Figure 9).…”

Personal Health Perceptions as Predictors to Medication Adherence in a Prospective Cohort Study Among Patients with Multiple Sclerosis

“…Indeed, a review on adherence in autoimmune conditions also concluded that economic, demographic, and clinical characteristics were only moderately linked to adherence or persistence (21). The ndings on the prospective association of beliefs about medication with adherence and persistence in medication taking is congruent with previous work in other conditions (37)(38)(39). Still, beliefs about medication were scarcely studied among PwMS; the only study that examined adherence to DMTs was cross-sectional and found no association between medication beliefs and adherence (13).…”

Predicting the risk of sarcopenia in elderly patients with patellar fracture: Development and assessment of a new predictive nomogram

“…Additionally, the nomogram prediction model has well-defined quantitative indicators, which facilities accurate evaluation of treatment outcome and prognosis. 31 In this paper, we describe, for the first time, the use of a nomogram model for the assessment of the risk of post-fracture sarcopenia.…”

“…Internal sampling showed that the model has strong predictive ability, while high values of C-index and AUC suggest that this model can be widely used for the prediction of postoperative sarcopenia in patients, with good accuracy. 31…”