Impact of beliefs about medication on the relationship between trust in physician with medication adherence after stroke

Fan, Qianqian; Doshi, Kinjal; Narasimhalu, Kaavya; Shankari, G.; Wong, Pei Shieen; Tan, Il Fan; Ng, Szu Chyi; Goh, Si Ying; Woon, Fung Peng; Silva, Deidre Anne De

doi:10.1016/j.pec.2021.07.016

Cited by 9 publications

(14 citation statements)

References 34 publications

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“…This is similar to literature data in other studies on MA and BMQ among PwMS [ 16 , 33 ]. Our results are not consistent with previous studies that evaluated the necessity of taking medicines in stroke and asthma patients [ 34 , 35 ]. One possible explanation is a different evolution of the symptoms in stroke survivors and patients with asthma exacerbation because of instant disability (i.e., hemiparesis and dyspnea).…”

Section: Discussioncontrasting

confidence: 99%

Psychometric evaluation of the 5-item Medication Adherence Report Scale questionnaire in persons with multiple sclerosis

Jožef,

Locatelli,

Brecl Jakob

et al. 2024

PLoS ONE

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The 5-item Medication Adherence Report Scale (MARS-5) is a reliable and valid questionnaire for evaluating adherence in patients with asthma, hypertension, and diabetes. Validity has not been determined in multiple sclerosis (MS). We aimed to establish criterion validity and reliability of the MARS-5 in persons with MS (PwMS). Our prospective study included PwMS on dimethyl fumarate (DMF). PwMS self-completed the MARS-5 on the same day before baseline and follow-up brain magnetic resonance imaging (MRI) 3 and 9 months after treatment initiation and were graded as highly and medium adherent upon the 24-cut-off score, established by receiver operator curve analysis. Health outcomes were represented by relapse occurrence from the 1st DMF dispense till follow-up brain MRI and radiological progression (new T2 MRI lesions and quantitative analysis) between baseline and follow-up MRI. Criterion validity was established by association with the Proportion of Days Covered (PDC), new T2 MRI lesions, and Beliefs in Medicines questionnaire (BMQ). The reliability evaluation included internal consistency and the test-retest method. We included 40 PwMS (age 37.6 ± 9.9 years, 75% women), 34 were treatment-naive. No relapses were seen during the follow-up period but quantitative MRI analysis showed new T2 lesions in 6 PwMS. The mean (SD) MARS-5 score was 23.1 (2.5), with 24 PwMS graded as highly adherent. The higher MARS-5 score was associated with higher PDC (b = 0.027, P<0.001, 95% CI: (0.0134–0.0403)) and lower medication concerns (b = -1.25, P<0.001, 95% CI: (-1.93-(-0,579)). Lower adherence was associated with increased number (P = 0.00148) and total volume of new T2 MRI lesions (P = 0.00149). The questionnaire showed acceptable internal consistency (Cronbach α = 0.72) and moderate test-retest reliability (r = 0.62, P < 0.0001, 95% CI: 0.33–0.79). The MARS-5 was found to be valid and reliable for estimating medication adherence and predicting medication concerns in persons with MS.

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Section: Discussioncontrasting

confidence: 99%

Psychometric evaluation of the 5-item Medication Adherence Report Scale questionnaire in persons with multiple sclerosis

Jožef,

Locatelli,

Brecl Jakob

et al. 2024

PLoS ONE

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“…Considering that a significantly higher proportion of respondents were disabled (2.8% vs. 0.0%) and consumed more than two medications (76.4% vs. 32.0%), as well as a lower proportion of normal workers (9.7% vs. 20.8%) in the PSD group, we speculate that this counterintuitive result might be mainly due to the stronger belief in taking medicine in the PSD population, which is inspired by an intensive willingness to alleviate pain due to severe post-stroke complications, including dysphagia. Strong medication beliefs, as suggested by recent studies [41][42][43], are strongly associated with medication adherence in stroke patients, partly supporting our inference. Additionally, we corroborated the findings of other related studies on the positive correlation of old age and male sex with medication compliance in stroke patients [42][43][44], further enhancing the credibility of our study on the counterintuitive results discussed above.…”

Section: Discussionsupporting

confidence: 90%

Status quo, perception, and preference of secondary prevention medications in post-stroke dysphagia patients: Time to raise awareness and develop special formulations

Yu,

Yang,

Katas

2024

Preprint

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Post-stroke dysphagia (PSD) is an increasingly common complication of stroke. Despite its intuitively unfavorable impact on secondary prevention medication use, limited awareness is available regarding this issue. Herein, a cross-sectional survey was conducted to determine the current use, patient-perceived needs and preferences for secondary prevention medications among PSD patients. To highlight the special situation arising from dysphagia, Chinese stroke patients with a duration of under five years were recruited and categorized into PSD and non-PSD groups by initial survey. Only the PSD group continued the needs and preference surveys. Among the 3,490 eligible respondents, 42.7% reported experiencing dysphagia after stroke. Those PSD respondents were more likely to consume multiple medications and suffer from anticoagulants-associated gastrointestinal bleeding as compared to non-PSD ones (p<0.001). More crucially, 40.2% of them had frequent difficulty in swallowing pills, 37.1% routinely crushed solid oral dosage forms (SODFs), and 23.5% coughed frequently when taking SODFs. In consequence, 87.4% responded a need for PSD-specific formulations where safe swallowing, easy swallowing, and reduced medication frequency were preferred pharmaceutical factors.These findings demonstrate an unsatisfactory situation and definite needs for PSD patients in using secondary prevention medications. Awareness should be increased to develop PSD-specific formulations for safe and effective secondary prevention.

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“…Six studies have shown that medication beliefs were significantly associated with medication adherence. 34 , 36 , 37 , 39–41 For example, a cohort study conducted by Fan et al determined whether beliefs about medication would mediate the relationship between trust in physicians and medication adherence. The result demonstrated that participants who were concerned about their medications and believed that doctors overuse them were likely not to take medications regularly.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…The result demonstrated that participants who were concerned about their medications and believed that doctors overuse them were likely not to take medications regularly. 36 Likewise, Ruksakulpiwat et al stated that a high score on the IS medication-concerned questionnaire was a barrier to medication adherence. 40 Therefore, results from these studies recommended that future interventions to improve medication adherence may benefit from addressing their beliefs about medication, and patients’ beliefs about IS medication should be included as one component in future interventions.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…The Patient-Physician Relationship is one of several factors that impact medication adherence in patients with IS. 36 , 39 , 41 A previous cohort study investigated the relationship between medication adherence, physician trust, and medication beliefs among stroke survivors. 36 The results demonstrated that a lack of trust in physicians prevented IS patients from taking their medications regularly.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

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Utilizing Social Determinants of Health Model to Understand Barriers to Medication Adherence in Patients with Ischemic Stroke: A Systematic Review

Ruksakulpiwat,

Benjasirisan,

Ding

et al. 2023

PPA

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Introduction Ischemic strokes and their recurrence create an immense disease burden globally. Therefore, preventing recurrent strokes by promoting medication adherence is crucial to reduce morbidity and mortality. In addition, understanding the barriers to medication adherence related to the social determinants of health (SDoH) could promote equity among persons with ischemic stroke. Objective To explore the barriers to medication adherence among patients with ischemic stroke through the SDoH. Methods This systematic review included studies published between January 2018 and December 2022 identified through PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text. The descriptions of the studies were systematically summarized and discussed based on the SDoH from the US Healthy People 2030 initiative. Results Eight studies met the inclusion criteria and were included in this review. The most common barrier to adherence was inappropriate medication beliefs, medication side effects, and patient-physician relationship, which relate to the dimensions of healthcare access and quality. Health literacy and health perception, dependent on education access and quality, frequently influenced adherence. Other social determinants, such as financial strain and social and community context, were found to alter adherence behaviors. No study addressed the neighborhood and built environment domain. We found that cognitive impairment is another factor that impacts adherence outcomes among stroke patients. Conclusion Multifaceted approaches are needed to address the SDoH to improve medication adherence among patients with ischemic stroke. This review emphasized strategies, including patient education, provider-patient communication, social support, health literacy, technology, and policy advocacy to enhance adherence.

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Impact of beliefs about medication on the relationship between trust in physician with medication adherence after stroke

Cited by 9 publications

References 34 publications

Psychometric evaluation of the 5-item Medication Adherence Report Scale questionnaire in persons with multiple sclerosis

Psychometric evaluation of the 5-item Medication Adherence Report Scale questionnaire in persons with multiple sclerosis

Status quo, perception, and preference of secondary prevention medications in post-stroke dysphagia patients: Time to raise awareness and develop special formulations

Utilizing Social Determinants of Health Model to Understand Barriers to Medication Adherence in Patients with Ischemic Stroke: A Systematic Review

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