Data on medication adherence in adults with neurological disorders: The NeuroGerAd study

Prell, Tino; Schönenberg, Aline; Mendorf, Sarah; Mühlhammer, Hannah M.; Großkreutz, Julian; Teschner, Ulrike

doi:10.1038/s41597-022-01847-9

Cited by 3 publications

(3 citation statements)

References 32 publications

(36 reference statements)

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“…Detailed information on the study can be found in the corresponding data descriptor. 13 In short, 2021 patients aged 55 years and above were admitted to the department during the data collection phase, of which 113 could not be approached before discharge. Of the remaining 1908 patients, 997 were excluded because they did not meet the inclusion criteria, were physically unable or declined to participate.…”

Section: Methodsmentioning

confidence: 99%

“…This paper reports explorative analyses of the cross-sectional dataset from the NeuroGerAd study,11 which is a longitudinal observational study in older hospitalised adults with neurological disorders (registered in the German Clinical Trials Register DRKS00016774; registered on 19 February 2019) 12 13. Briefly, from February 2019 to March 2020, elderly patients with neurological disorders received a comprehensive geriatric assessment during their stay in the Department of Neurology at the Jena University Hospital.…”

Section: Methodsmentioning

confidence: 99%

“…Detailed information on the study can be found in the corresponding data descriptor 13. In short, 2021 patients aged 55 years and above were admitted to the department during the data collection phase, of which 113 could not be approached before discharge.…”

Section: Methodsmentioning

confidence: 99%

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Using a generic quality of life measure to determine adherence thresholds: a cross-sectional study on older adults with neurological disorders in Germany

2023

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ObjectivesMeasuring the degree of adherence to medication is essential in healthcare However, the cut-offs provided for adherence scales are often arbitrary and disease-specific, and need to be validated against a clinical outcome. Here, we used health-related quality of life (QoL) to determine cut-offs for a self-report adherence questionnaire in patients with neurological diagnoses.DesignCross-sectional study.Participants910 patients (age 70±8.6 years) with neurological disorders were recruited from the wards of neurology at a local university hospital. All patients received a comprehensive geriatric assessment, including assessments of adherence (Stendal Adherence to Medication Score, SAMS) and QoL (Short Form Survey SF-36).Outcome measuresThe main aim of the study was to define a cut-off for non-adherence at which QoL is significantly impaired. Thus, we used Spearman’s rank correlation, multivariate and univariate analyses of variance to test the impact of different adherence levels on QoL. Receiver operating characteristics and area under curve measures were then used to determine cut-off scores for adherence based on significant differences in QoL.ResultsCorrelations between SAMS and SF-36 domains were weak (ranging between r=−0.205 for emotional well-being and r=−0.094 for pain) and the effect of non-adherence on QoL disappeared in the multivariate analysis of variance (p=0.522) after adjusting for demographical and clinical factors. SAMS cut-offs in terms of SF-36 domains varied greatly, so that an overall SAMS cut-off for this cohort could not be defined.ConclusionsQoL as measured by the SF-36 is not suitable as a single outcome parameter to study the impact of non-adherence on QoL in a mixed neurological cohort. Since both QoL and adherence are heterogeneous, multifaceted constructs, it is unlikely to find an overarching cut-off applicable for all patients. Thus, it may be necessary to use disease or cohort-specific external outcome parameters to measure the indirect effect of interventions to enhance adherence.Trial registration numberDRKS00016774.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Using a generic quality of life measure to determine adherence thresholds: a cross-sectional study on older adults with neurological disorders in Germany

2023

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Impact of depressive symptoms on medication adherence in older adults with chronic neurological diseases

Schönenberg,

Heimrich,

Prell

2024

BMC Psychiatry

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Background Nonadherence to medication contributes substantially to worse health outcomes. Especially among older adults with chronic illness, multimorbidity leads to complex medication regimes and high nonadherence rates. In previous research, depressive symptomology has been identified as a major contributor to nonadherence, and some authors hypothesize a link via motivational deficits and low self-efficacy. However, the exact mechanisms linking depressive symptomology and nonadherence are not yet understood. This is in part because the often-employed sum scores cannot do justice to the complexity of depressive symptomology; instead, it is recommended to assess the influence of individual symptoms. Methods Following this symptom-based approach, we performed correlation, network and regression analysis using depressive symptoms as depicted by the items of the revised Beck Depression Inventory II (BDI) to assess their influence with nonadherence in N = 731 older adults with chronic neurological diseases. Nonadherence was measured with the self-report Stendal Adherence to Medication Score (SAMS). Results Even when controlling for sociodemographic and health-related covariates, the BDI remained the most influential contributor to nonadherence. Across different methods, Loss of Interest and Difficulty with Concentration were identified as particularly influential for nonadherence, linking nonadherence with other affective or somatic BDI items, respectively. Additionally, Fatigue, Problems with Decision Making, Suicidal Thoughts, and Worthlessness contribute to nonadherence. Conclusion Using a symptom-driven approach, we aimed to understand which depressive symptoms contribute to higher levels of nonadherence. Our results refine previous hypotheses about motivation and control beliefs by suggesting that it is not merely a lack of beliefs in the efficacy of medication that connects depressive symptoms and nonadherence, but rather an overall lack of interest in improving one’s health due to feelings of worthlessness and suicidal tendencies. This lack of interest is further substantiated by already sparse resources caused by changes in concentration and fatigue. In order to improve health outcomes and reduce nonadherence, these associations between depressive symptoms must be further understood and targeted in tailored interventions.

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Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders

Schwarzkopf

Schönenberg

Prell

2022

JCM

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Background: Medication is often changed after inpatient treatment, which affects the course of the disease, health behavior and adherence. Thus, it is important to understand patterns of medication changes after discharge from hospital. Methods: Inpatients at the Department of Neurology received a comprehensive assessment during their stay, including adherence, depression, cognition, health and sociodemographic variables. A month after being discharged, patients were contacted to enquire about post-discharge medication changes. Results: 910 older adults aged 70 ± 8.6 years participated, of which 204 (22.4%) reported medication changes. The majority of changes were initiated by physicians (n = 112, 56.3%) and only 25 (12.6%) patients reported adjusting medication themselves. Reasons for medication changes differed between patients and doctors (p < 0.001), with side effects or missing effects cited frequently. Sociodemographic and patient-related factors did not significantly predict medication changes. Conclusion: Patients reported less post-discharge medication changes than expected, and contrary to previous literature on nonadherence, only a fraction of those changes were performed by patients themselves. Socioeconomic and clinical parameters regarding personality, mood and cognition were poorly associated with post-discharge medication changes. Instead, individual health-related factors play a role, with patient factors only indirectly influencing physicians’ decisions.

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Data on medication adherence in adults with neurological disorders: The NeuroGerAd study

Cited by 3 publications

References 32 publications

Using a generic quality of life measure to determine adherence thresholds: a cross-sectional study on older adults with neurological disorders in Germany

Using a generic quality of life measure to determine adherence thresholds: a cross-sectional study on older adults with neurological disorders in Germany

Impact of depressive symptoms on medication adherence in older adults with chronic neurological diseases

Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders

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