Determinants of patient adherence: a review of systematic reviews

Kardas, Przemysław; Lewek, Paweł; Matyjaszczyk, Michał

doi:10.3389/fphar.2013.00091

Cited by 578 publications

(641 citation statements)

References 59 publications

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“…Antihypertensive adherence might be a particular concern for older adults who have multiple chronic conditions 4, 5, 6, 8, 20. Many studies have examined major barriers and predictors of nonadherence among hypertensive patients,5, 7, 9, 11, 44, 45 and some focused on older adults 6, 46. Potential barriers to adherence among older adults can be classified into 3 categories: (1) patient‐related factors, including sociodemographics, psychosocial factors, comorbidities, cognitive ability, and health beliefs; (2) medication‐related factors, including the number of medications taken, adverse side effects, and complex medication regimens; and (3) other factors, including the patient‐prescriber relationship, access to medication and cost, and social support 6, 46.…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population‐Based Cohort Study

Yang

Chang

Ritchey

et al. 2017

JAHA

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BackgroundAntihypertension medication (antihypertensive) adherence lowers risk of cardiovascular disease (CVD); few studies have examined this association among older adults.Methods and ResultsWe assessed this association among Medicare fee‐for‐service beneficiaries aged 66 to 79 years who were newly diagnosed with hypertension and initiated on antihypertensives in 2008–2009 (n=155 597). We calculated proportion of days covered (PDC) during follow‐up, using proportional subdistribution hazard models, to examine association between antihypertensive adherence and a composite CVD outcomes, including first incident of fatal/nonfatal acute myocardial infarction, ischemic heart disease, stroke/transient ischemic attack, and heart failure. During follow‐up (median 5.8 years and 798 621 person‐years), we documented 47 198 CVD events. Among beneficiaries, 60.8%, 30.3%, and 8.9% had PDC ≥80%, 40% to 79%, and <40%. Crude incidence of CVD events were 40.1 (95% CI, 40.0–40.1), 93.9 (93.8–93.9), and 98.1 (98.1–98.2) per 1000 person‐years for PDC ≥80%, 40% to 79%, and <40%, respectively. Adjusted hazard ratios for CVD events were 1.0 (<40% as reference), 1.0 (0.97–1.03) for 40% to 79%, and 0.44 (0.42–0.45) for ≥80% (P<0.001). Dose‐response analysis suggested a nonlinear relationship between PDC and risk for CVD events with a protective effect of ≥80%. The pattern of associations between PDC and ischemic heart disease, stroke/transient ischemic attack, and heart failure were largely consistent as for CVD events and across different groups.ConclusionsAntihypertensive adherence was associated with a significantly lower risk of CVD events among older adults. There appeared to be a threshold effect in reducing CVD events at around PDC 80%, above which the risk for CVD reduced substantially.

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Section: Discussionmentioning

confidence: 99%

Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population‐Based Cohort Study

Yang

Chang

Ritchey

et al. 2017

JAHA

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“…Whether related to the pharmacological action of a medication or not, side effects can reduce patient well‐being and be a cause of patient non‐adherence (Ammassari et al ., 2001; Kardas, Lewek, & Matyjaszczyk, 2013), both of which can lead to a significant cost to health services (National Institute For Health and Clinical Excellence, 2009). To reduce the negative impact of side effects, it is important to understand more about their causes.…”

Section: Introductionmentioning

confidence: 99%

Medicine‐related beliefs predict attribution of symptoms to a sham medicine: A prospective study

Webster

Weinman

Rubin

2018

British J Health Psychol

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ObjectivesTo investigate a range of possible predictors of nocebo responses to medicines.DesignProspective cohort study.MethodsIn total, 203 healthy adult volunteers completed measures concerning demographics, psychological factors, medicine‐related beliefs, baseline symptoms, and symptom expectations before taking a sham pill, described as ‘a well‐known tablet available without prescription’ that was known to be associated with several side effects. Associations between these measures and subsequent attribution of symptoms to the tablet were assessed using a hurdle model consisting of a joint logistic and truncated negative binomial regression.ResultsMen had an increased odds of attributing symptoms to the tablet OR = 1.52, and older participants had decreased odds, OR = 0.97. Medicine‐related beliefs were important, with modern health worries, belief that medicines cause harm and perceived sensitivity to medicines associated with increased odds of symptom attribution, OR = 1.02, 1.10, 1.09, respectively. Trust in medicines and pharmaceutical companies decreased the odds of symptom attribution, OR = 0.91, 0.88, respectively. The number of symptoms at baseline and the expected likelihood of symptoms were associated with an increased odds of attributing symptoms to the tablet, OR = 1.07, 1.06, respectively. Anxiety, previous symptom experience, symptom expectations, and modern health worries were also important in predicting the number of symptoms participants attributed to the tablet.ConclusionIt is hard to predict who is at risk of developing nocebo responses to medicines from demographic or personality characteristics. Context‐specific factors such as beliefs about and trust in medicines, current symptoms and symptom expectations are more useful as predictors. More work is needed to investigate this in a patient sample. Statement of contribution What is already known on this subject? Many patients report non‐specific side effects to their medication which may arise through a nocebo effect.Whether some people are particularly predisposed to experience nocebo effects remains unclear. What does this study add? Demographic and personality characteristics are poor predictors of symptom attribution to a sham medicine.Instead, context‐specific factors that concern people's beliefs surrounding medicines, their current symptoms, and symptom expectations are more useful as predictors of symptom attribution.

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“…Reasons for nonadherence among patients with BD include the following: a denial of the diagnosis, especially in those with predominant mania; a lack of belief that the medications being offered are necessary or effective; and a wish to avoid the real or imagined adverse effects of medications (Devulapalli et al., 2010). Additional practical factors, including poor access to health care and limited resources to support treatment costs, can also affect adherence (Kardas, Lewek, & Matyjaszczyk, 2013). …”

Section: Major Challenges In the Management Of Patients With Bdmentioning

confidence: 99%

Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

McCormick

Murray

McNew

2015

Journal of the American Association of Nurse Practitioners

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Purpose This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced practice nurses (APNs). Data sources PubMed searches were conducted using the following keywords: “bipolar disorder and primary care,” restricted to dates 2000 to present; “bipolar disorder and nurse practitioner”; and “bipolar disorder and clinical nurse specialist.” Selected articles were relevant to adult outpatient care in the United States, with a prioritization of articles written by APNs or published in nursing journals. Conclusions BD has a substantial lifetime prevalence in the population at 4%. Because the manic or depressive symptoms of BD tend to be severe and recurrent over a patient's lifetime, the condition is associated with significant burden to the individual, caregivers, and society. Clinician awareness that BD may be present increases the likelihood of successful recognition and appropriate treatment. A number of pharmacological and nonpharmacological treatments are available for acute and maintenance treatments, with the prospect of achieving reduced symptom burden and increased functioning for many patients. Implications for practice Awareness of the disease burden, diagnostic issues, and management choices in BD has the potential to enhance outcome in substantial proportions of patients.

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Determinants of patient adherence: a review of systematic reviews

Cited by 578 publications

References 59 publications

Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population‐Based Cohort Study

Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population‐Based Cohort Study

Medicine‐related beliefs predict attribution of symptoms to a sham medicine: A prospective study

Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

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