Incomplete medication adherence of chronically ill patients in German primary care

Hüther, Jakob; Wolff, Alessa von; Stange, Dorit; Härter, Martin; Baehr, Michael; Dartsch, Dorothee C.; Kriston, Levente

doi:10.2147/ppa.s38373

Cited by 17 publications

(21 citation statements)

References 41 publications

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“…This is important as dysregulation of the normal myelination trajectory may contribute to the functional deterioration and treatment resistance observed in chronic schizophrenia [139]. The clinical imperative to reduce relapse rates stems also from the added economic burden of treating relapse, possibly leading to unavoidable hospital admissions [134,[141][142][143][144][145][146][147]. Finally, relapses due to medication non-adherence can have devastating social consequences themselves.…”

Section: Results Of Descriptivementioning

confidence: 99%

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

et al. 2015

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With continuous treatment, patients have a lower risk of relapse and remain relapse free for a longer period of time compared with placebo and intermittent treatment strategies. Moreover, 'success rates' in the intermittent treatment conditions are expected to be an overestimate of actual outcome rates. Therefore, continuous treatment remains the 'gold standard' for good clinical practice, particularly as, until now, only a few and rather general valid predictors for relapse in schizophrenia are known and subsequent relapses may contribute to functional deterioration as well as treatment resistance in patients with schizophrenia.

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Section: Results Of Descriptivementioning

confidence: 99%

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

et al. 2015

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“…(29) The instrument has been used in a variety of populations, and across multiple chronic diseases, including COPD. (27, 30–35) The 10 items included in the instrument address primary medication use and are phrased to avoid social desirability bias. (29) Responses are scored on a 5-point Likert scale, and a final score is assigned based on the average of the 10 responses.…”

Section: Methodsmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease Illness and Medication Beliefs are Associated with Medication Adherence

Krauskopf

Federman

Kale

et al. 2014

COPD: Journal of Chronic Obstructive Pulmonary Disease

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Almost half of patients with COPD do not adhere to their medications. Illness and medication beliefs are important determinants of adherence in other chronic diseases. Using the framework of the Common Sense Model of Self Regulation (CSM), we determined associations between potentially modifiable beliefs and adherence to COPD medications in a cohort of English- and Spanish-speaking adults with COPD from New York and Chicago. Medication adherence was assessed using the Medication Adherence Report Scale. Illness and medication beliefs along CSM domains were evaluated using the Brief Illness Perception Questionnaire (B-IPQ) and the Beliefs about Medications Questionnaire (BMQ). Unadjusted analysis (with Cohen’s d effect sizes) and multiple logistic regression were used to assess the relationship between illness and medication beliefs with adherence. The study included 188 participants (47% Black, 13% Hispanics); 109 (58%) were adherent. Non-adherent participants were younger (p<0.001), more likely to be Black or Hispanic (p=0.001), to have reported low income (p=0.02), and had fewer years of formal education (p=0.002). In unadjusted comparisons, non-adherent participants reported being more concerned about their COPD (p=0.011; Cohen’s d=0.43), more emotionally affected by the disease (p=0.001; Cohen’s d=0.54), and had greater concerns about COPD medications (p<0.001, Cohen’s d=0.81). In adjusted analyses, concerns about COPD medications independently predicted non-adherence (odds ratio: 0.52, 95% confidence interval: 0.36–0.75). In this cohort of urban minority adults, concerns about medications were associated with non-adherence. Future work should explore interventions to influence patient adherence by addressing concerns about the safety profile and long-term effects of COPD medications.

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“…For example, we considered obesity as a potentially important unmeasured confounder because obesity is a major predictor of diabetes (15) and can influence adherence to statin therapy (16,17), which means that failing to adjust for its effects can move the results toward or away from the null. We made a quantitative assessment of the obesity-related bias by using the Monte Carlo sensitivity analysis (18).…”

Section: Sensitivity Analysesmentioning

confidence: 99%

“…We made a quantitative assessment of the obesity-related bias by using the Monte Carlo sensitivity analysis (18). We set 1) the prevalence of the obesity among users of statins to 37.5% (19), 2) the risk of diabetes in obese patients to threefold higher than in normal weight patients (15), and 3) the odds of obese patients belonging to the highest PDC category from twofold lower to twofold higher than that of normal weight patients (16,17). The Monte Carlo sensitivity analysis corrected the observed HRs for the bias factor calculated from the previously mentioned data and took into account random uncertainty for adjusting estimates.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study

et al. 2014

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OBJECTIVETo investigate the relationship between adherence with statin therapy and the risk of developing diabetes. RESEARCH DESIGN AND METHODSThe cohort comprised 115,709 residents of the Italian Lombardy region who were newly treated with statins during 2003 and 2004. Patients were followed from the index prescription until 2010. During this period, patients who began therapy with an antidiabetic agent or were hospitalized for a main diagnosis of type 2 diabetes were identified (outcome). Adherence was measured by the proportion of days covered (PDC) with statins (exposure). A proportional hazards model was fitted to estimate hazard ratios (HRs) and 95% CIs for the exposure-outcome association, after adjusting for several covariates. A set of sensitivity analyses was performed to account for sources of systematic uncertainty. RESULTSDuring follow-up, 11,154 cohort members experienced the outcome. Compared with patients with very-low adherence (PDC <25%), those with low (26-50%), intermediate (51-75%), and high ( ‡75%) adherence to statin therapy had HRs (95% CIs)

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Incomplete medication adherence of chronically ill patients in German primary care

Cited by 17 publications

References 41 publications

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

Chronic Obstructive Pulmonary Disease Illness and Medication Beliefs are Associated with Medication Adherence

Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study

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