Beliefs about medicines in dialysis patients and after renal transplantation

Abstract

Introduction: Patients with end‐stage renal disease are burdened by a complex medication regimen, but little is known about the belief about medicine among dialysis‐ and renal transplant (RTX) patients. Patients’ beliefs about medicines may influence drug adherence and thereby affect morbidity and mortality. The aim of the present study was to assess the beliefs about medicine in dialysis as well as after RTX. Methods: In a prospective study, 301 dialysis patients were followed for up to 5.5 years during which time 142 had been transplanted. Out of the transplanted patients, 110 were eligible for inclusion. The Beliefs about Medicine Questionnaire (BMQ) was used to assess the beliefs in dialysis and after transplantation. BMQ in dialysis was also compared to that of the general Norwegian population (n = 426). Multiple linear regression analyses were performed with BMQ subscales as dependent variables and sociodemographic and clinical data as independent variables. Findings: Median age in dialysis was 62 (IQR 50‐73) years, 66.1% were male and 80.7% were treated with hemodialysis. When in dialysis, 98.2% strongly believed their medications were necessary, while 34.4% reported strong concerns. Furthermore, 17.3% believed their medications to be harmful and 38.6% believed that doctors overprescribed medicines. The Necessity‐concern differential had a positive score in 92.6% of the patients. Follow‐up time was 55 (IQR 50‐59) months. After transplantation, there was an increase in the patient‐reported necessity of medication (21.9 ± 2.7 vs. 23.8 ± 1.9, P < 0.001) compared to while in dialysis. Correlations were found between patient beliefs and education, age, and depression. Discussion: Although positive beliefs about medicines increase after transplantation, concerns are high in both dialysis and after RTX. Implementing the BMQ routinely in the clinical evaluation of dialysis‐ and RTX patients may help to identify patients with increased risk for medical nonadherence.

Illness perceptions and beliefs about medication: impact on health‐related quality of life in adolescent kidney transplant recipients

“…Results also indicated that adolescents in this sample perceived the benefits of their medications to outweigh the consequences, similar to previous findings. 26,28 This suggests that adolescents may understand and accept the necessity of taking their prescribed medications post-transplant but that their transplant-specific HRQOL is affected by other considerations such as concerns about long-term overuse and potential harm of the transplant regimen.…”

“…In a prior study, younger adolescents expressed greater concerns about medications than older adolescents, with stronger beliefs about the harmfulness of their medications 25 . Among adults on dialysis and kidney transplant, 34.4% reported strong concerns about their medications (eg, long‐term effects, dependence) and 17.3% believed their medications to be harmful, while the majority (98.2%) strongly believed their medications to be necessary for their physical well‐being 26 . Patient beliefs that medication is necessary was related to better adherence in dialysis patients 27 while lower perceived benefits, perceived harmfulness, and greater concerns about medication were associated with lower adherence in transplant samples 28‐30 .…”

“…25 Among adults on dialysis and kidney transplant, 34.4% reported strong concerns about their medications (eg, long-term effects, dependence) and 17.3% believed their medications to be harmful, while the majority (98.2%) strongly believed their medications to be necessary for their physical wellbeing. 26 Patient beliefs that medication is necessary was related to better adherence in dialysis patients 27 while lower perceived benefits, perceived harmfulness, and greater concerns about medication were associated with lower adherence in transplant samples. [28][29][30] Although beliefs about medication have been studied in adult dialysis and transplant patients, there is not comparable research examining the role of medication beliefs in health outcomes such as quality of life for adolescent kidney transplant patients.…”

Usability and perceived usefulness of patient-centered medication reconciliation using a personalized health record: a multicenter cross-sectional study

“…Besides that, PHR users who had a negative opinion about the PHR and/or had a suggestion to improve the PHR were potentially more motivated to participate in this study which may have caused inclusion bias. Furthermore, Marien et al included patients with pulmonary transplants who have potentially a higher perceived usefulness of their (live saving) drugs compared to our study sample [ 34 ].…”

Determining the Factors Affecting the Beliefs of Patients with Cancer on Immunotherapy Medications

“…Bu nedenle ilaç inancını etkileyen faktörleri belirlemek sağlık sonuçlarını iyileştirmek için çok önemlidir. Son yıllarda farklı ilaçlara karşı hastaların ilaç inancını inceleyen çalışmalarda; çoklu ilaç kullanımı, yaş, etnik köken, çevresel faktörler, hastanın hastalık ve tedavi ile ilgili inancı, düşüncesi ve bilgisi, gibi faktörlerin tedaviye uyum düzeyini etkileyebileceği ifade edilmiştir (16)(17)(18)(19). Bu faktörler arasında, hastaların ilaçlar hakkında inançları, ilaca uyum açısından güçlü bir faktör olarak değerlendirilmektedir.…”