Changes in beliefs about medications during long-term care for ischemic heart disease

LaPointe, Nancy M. Allen; Ou, Fang Shu; Calvert, Sara B.; Melloni, Chiara; Stafford, Judith A.; Harding, Tina; Alexander, Karen P.; Peterson, Eric D.

doi:10.1016/j.ahj.2009.12.025

Cited by 24 publications

(17 citation statements)

References 24 publications

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“…Higher scores on the negative domains (concern, overuse, and harm) were associated statistically with both mood and somatization. Higher scores in the concern domain have been shown to be associated with depression, anxiety, and neuroticism across varying disease states (11,12,25). Depression and anxiety also were associated with higher necessity scores.…”

Section: Discussionmentioning

confidence: 99%

Beliefs About GI Medications and Adherence to Pharmacotherapy in Functional GI Disorder Outpatients

Cassell

et al. 2015

American Journal of Gastroenterology

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OBJECTIVES Pharmacotherapy is a mainstay in functional gastrointestinal (GI) disorder (FGID) management, but little is known about patient attitudes toward medication regimens. Understanding patient concerns and adherence to pharmacotherapy is particularly important for off-label medication use (e.g., anti-depressants) in FGID. METHODS Consecutive tertiary GI outpatients completed the Beliefs About Medications questionnaire (BMQ). Subjects were categorized as FGID and structural GI disease (SGID) using clinician diagnoses and Rome criteria; GI-specific medications and doses were recorded, and adherence to medication regimens was determined by patient self-report. BMQ domains (overuse, harm, necessity, and concern) were compared between FGID and SGID, with an interest in how these beliefs affected medication adherence. Psychiatric measures (depression, anxiety, and somatization) were assessed to gauge their influence on medication beliefs. RESULTS A total of 536 subjects (mean age 54.7±0.7 years, range 22–100 years; n=406, 75.7% female) were enrolled over a 5.5-year interval: 341 (63.6%) with FGID (IBS, 64.8%; functional dyspepsia, 51.0%, ≥2 FGIDs, 38.7%) and 142 (26.5%) with SGID (IBD, 28.9%; GERD, 23.2%). PPIs (n=231, 47.8%), tricyclic antidepressants (TCAs) (n=167, 34.6%), and anxiolytics (n=122, 25.3%) were common medications prescribed. FGID and SGID were similar across all BMQ domains (P>0.05 for overuse, harm, necessity, and concern). SGID subjects had higher necessity-concern framework (NCF) scores compared with FGID subjects ( P=0.043). FGID medication adherence correlated negatively with concerns about medication harm (r=−0.24, P<0.001) and overuse (r=−0.15, P=0.001), whereas higher NCF differences predicted medication compliance (P=0.006). Medication concern and overuse scores correlated with psychiatric comorbidity among FGID subjects (P<0.03 for each). FGID patients prescribed TCAs (n=142, 41.6%) expressed a greater medication necessity (17.4±0.4 vs. 16.2±0.4, P=0.024) and found their GI regimen to be more helpful (P=0.054). FGID subjects not on TCAs expressed a greater apprehension about medication overuse (10.7±0.3 vs. 9.7±0.2, P=0.002) on the BMQ. CONCLUSIONS FGID subjects report medication necessity and concern scores comparable to patients with SGID but have negative perceptions about medications, particularly in the presence of psychiatric comorbidity; these factors may affect treatment adherence and willingness to initiate neuromodulator regimens.

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Section: Discussionmentioning

confidence: 99%

Beliefs About GI Medications and Adherence to Pharmacotherapy in Functional GI Disorder Outpatients

Cassell

et al. 2015

American Journal of Gastroenterology

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“…The method can be used for descriptive purposes and for evaluation of change in scale assessments. There are alternative ways to evaluate the change14 where the proportions of patients whose necessity or concern score fell from higher than the midpoint to lower than the midpoint, or the opposite. However, this too defines that a change around the midpoint is discriminating, but we do not know if this bears any more meaning than changing from 10 to 5 on the concern scale.…”

Section: Discussionmentioning

confidence: 99%

Medication beliefs and self-reported adherence–results of a pharmacist's consultation: a pilot study

et al. 2014

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Objectives Clinical outcomes in the secondary prevention of cardiovascular disease depend on the patients’ adherence to prescribed medicines. Motivational interviewing (MI) is a patient-centred approach used to change different health behaviours. The objective of this pilot study was to explore the impact of a clinical pharmacist's consultation on beliefs about medicines and self-reported medication adherence among patients with coronary heart disease (CHD). Methods CHD-patients participating in a prevention programme at the Kalmar County Hospital were randomised to control or intervention. The intervention consisted of a medication review focused on cardiovascular drugs, and a semistructured interview based on MI-approach, with a follow-up phone call 2 weeks later. The intervention was conducted by a clinical pharmacist at the cardiology unit 3 months postdischarge. Primary outcome measures were the results from the Beliefs about Medicines-Specific (BMQ-S) and the 8-Item Morisky Medication Adherence Scale (MMAS-8) 2 weeks after intervention. Results 21 enrolled patients (11 intervention) all completed to follow-up. MMAS-8 was very similar in the intervention and control groups. In BMQ-S the intervention group had a mean (SD) necessity score of 21 (4) and a concern score of 12 (6), corresponding results in the control group were 21 (3) and 10 (5). However, since there was a difference in BMQ-S at baseline, seven intervention patients shifted towards more positive beliefs compared with two control patients. Conclusions No difference was found in adherence and beliefs at follow-up. However, after consultation, a larger proportion of patients changed towards more positive beliefs compared with control.

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“…In the target group of elderly individuals with multiple illnesses both acute events and substantial changes in health status are more probable in such relatively short time periods than in healthier populations (e.g., [28]). Such changes in turn affect how individuals think about their illnesses and accordingly their medication [17,29]. In addition, the limited amount of evidence from previous studies makes it difficult to determine optimal measurement intervals.…”

Section: Participants and Proceduresmentioning

confidence: 99%

Medication beliefs predict medication adherence in older adults with multiple illnesses

Schüz

Marx

Wurm

et al. 2011

Journal of Psychosomatic Research

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Changes in beliefs about medications during long-term care for ischemic heart disease

Cited by 24 publications

References 24 publications

Beliefs About GI Medications and Adherence to Pharmacotherapy in Functional GI Disorder Outpatients

Beliefs About GI Medications and Adherence to Pharmacotherapy in Functional GI Disorder Outpatients

Medication beliefs and self-reported adherence–results of a pharmacist's consultation: a pilot study

Medication beliefs predict medication adherence in older adults with multiple illnesses

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