Comparison of individual perceptions of medication costs and benefits between intentional and unintentional medication non-adherence among Japanese patients

Iihara, Naomi; Kurosaki, Yuji; Miyoshi, Chika; Takabatake, Kiyo; Morita, Satoru; Hori, Keizo

doi:10.1016/j.pec.2007.10.016

Cited by 17 publications

(31 citation statements)

References 35 publications

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“…Details of the study methods were presented in our previous article [3]. The setting, the inclusion and exclusion criteria for subjects, questionnaire, and the definition of non-adherence to medication are briefly reviewed below.…”

Section: Subject and Questionnairementioning

confidence: 99%

“…Each item in the BMQ is rated by the respondents on a five-point Likert scale, with 'one' indicating strong disagreement and 'five' indicating strong agreement. We used a version of the BMQ which we had translated into Japanese [3].…”

Section: Subject and Questionnairementioning

confidence: 99%

“…Despite ongoing efforts, effective interventions to improve upon nonadherence have not yet been found [2]. One proposed reason is that intentional and unintentional non-adherence may be different entities [3][4][5][6][7][8]. While intentional nonadherence is deliberate behavior involving their intentions, unintentional non-adherence is passive behavior such as forgetfulness to take medications [3][4][5][6][7], lack of attention [9], or misunderstanding instructions about schedules [4].…”

Section: Introductionmentioning

confidence: 99%

“…The BMQ scales are widely used to measure individual latent factors related to medication-taking behavior using scores that sum ratings for items on each scale [3,8,[11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, BMQ studies have started focusing on the differences in individual latent levels among intentionally and unintentionally non-adherent populations [3,8]. However, no studies have been performed on BMQ that examined the factorial invariance between such groups.…”

Section: Introductionmentioning

confidence: 99%

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Factorial invariance of a questionnaire assessing medication beliefs in Japanese non-adherent groups

et al. 2010

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Section: Subject and Questionnairementioning

confidence: 99%

Section: Subject and Questionnairementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The BMQ scales are widely used to measure individual latent factors related to medication-taking behavior using scores that sum ratings for items on each scale [3,8,[11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factorial invariance of a questionnaire assessing medication beliefs in Japanese non-adherent groups

et al. 2010

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Unintentional and intentional non-adherence to immunosuppressive medications in renal transplant recipients

2018

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Background Non-adherence to immunosuppressive medications following renal transplantation is a risk factor for rejection and graft loss. Despite the dire consequences, adherence lapses, both unintentional and intentional, are common and poorly understood. Objective The present study sets to compare the rates and determinants of unintentional, intentional and overall self-reported non-adherence. Setting Outpatient clinic at the National University Centre for Organ Transplantation, Singapore. Method This was a cross-sectional survey administered to N = 152 renal transplant recipients. Main outcome measure They completed the Transplant Effects Questionnaire, Beliefs about Medications Questionnaire, Multidimensional Scale of Perceived Social Support, the Depression, Anxiety and Stress Scale, and the Medication Adherence Report Scale. Clinical and laboratory information were also assessed. Results The prevalence rates for overall, unintentional, and intentional self-reported non-adherence were 19.7, 47.4, and 15.1% respectively. Unintentional non-adherence was predicted by engagement in formal work, a primary diagnosis of autoimmune nephritis, and being a recipient of a living-donor renal transplant (i.e. stable characteristics). In contrast, intentional non-adherence was predicted by co-morbid burden and patients' evaluation of the side effects of their medications. Overall non-adherence was predicted by a deliberate decision-making process involving the weighing of the costs of using immunosuppressive drugs against their perceived benefits. Conclusion The survey highlighted the importance of making a distinction between unintentional and intentional non-adherence in renal transplant recipients, and suggested that modifiable factors may be targeted in different ways in interventions to increase adherence.

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Intentional Non-Adherence to Medications by Older Adults

2014

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'The extent to which an individual's medication-taking behaviour and/or execution of lifestyle changes, corresponds with agreed recommendations from a healthcare provider', is a highly complex behaviour, defined as adherence. However, intentional non-adherence is regularly observed and results in negative outcomes for patients along with increased healthcare provision costs. Whilst this is a consistent issue amongst adults of all ages, the burden of chronic disease is greatest amongst older adults. As a result, the absolute prevalence of intentional non-adherence is increased in this population. This non-systematic review of intentional non-adherence to medication highlights the extent of the problem amongst older adults. It notes that age, per se, is not a contributory factor in intentionally non-adherent behaviours. Moreover, it describes the difference in methodology required to identify such behaviours in contrast to reports of non-adherence in general: the use of focus groups, semi-structured, one-to-one interviews and questionnaires as opposed to pill counts, electronic medication monitors and analysis of prescription refill rates. Using Leventhal's Common-Sense Model of Self-Regulation, it emphasizes six key factors that may contribute to intentional non-adherence amongst older adults: illness beliefs, the perceived risks (e.g. dependence, adverse effects), benefits and necessity of potential treatments, the patient-practitioner relationship, inter-current physical and mental illnesses, financial constraints and pharmaceutical/pharmacological issues (poly-pharmacy/regimen complexity). It describes the current evidence for each of these aspects and notes the paucity of data validating Leventhal's model in this regard. It also reports on interventions that may address these issues and explicitly acknowledges the lack of evidence-based interventions available to healthcare practitioners. As a result, it highlights five key areas that require urgent research amongst older adults: (1) the overlap between intentional and unintentional non-adherence, particularly amongst those who may be frail or isolated; (2) the potential correlation between symptomatic benefit and intentional vs. unintentional non-adherence to medication; (3) an evaluation of the source of prescribing (i.e. a long-standing provider vs. an acute episode of care) and the patient-prescriber relationship as determinants of intentional and unintentional non-adherence; (4) the decision-making processes leading to selective intentional non-adherence amongst older adults with multiple medical problems; and (5) the development and evaluation of interventions designed to reduce intentional non-adherence, specifically addressing each of the aspects listed above.

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Comparison of individual perceptions of medication costs and benefits between intentional and unintentional medication non-adherence among Japanese patients

Cited by 17 publications

References 35 publications

Factorial invariance of a questionnaire assessing medication beliefs in Japanese non-adherent groups

Factorial invariance of a questionnaire assessing medication beliefs in Japanese non-adherent groups

Unintentional and intentional non-adherence to immunosuppressive medications in renal transplant recipients

Intentional Non-Adherence to Medications by Older Adults

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