&lt;p&gt;Different Associations of Intentional and Non-Intentional Non-Adherence Behaviors with Patient Experience with Healthcare and Patient Beliefs in Medications: A Survey of Patients with Chronic Conditions&lt;/p&gt;

Cea‐Calvo, Luis; Marín-Jiménez, Ignacio; Toro, Javier de; Fuster‐RuizdeApodaca, María José; Fernández, Gonzalo; Sánchez-Vega, Nuria; Orozco‐Beltrán, Domingo

doi:10.2147/ppa.s281985

Cited by 15 publications

(20 citation statements)

References 26 publications

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“…There is an ongoing discussion in the literature regarding links between age and adherence. According to some available publications, younger patients have higher unintentional non-adherence levels, which are associated with their lifestyle and professional activity [ 35 , 36 ]. However, there are also publications reporting an adverse impact of elderly age or the associated cognitive impairment or frailty syndrome on adherence, resulting in higher levels of unintentional non-adherence to treatment [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Beliefs about Medicines on the Level of Intentional Non-Adherence to the Recommendations of Elderly Patients with Hypertension

Świątoniowska-Lonc

Polański

Mazur

et al. 2021

IJERPH

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Background: Non-adherence to pharmaceutical treatment is one of the most common causes of uncontrolled hypertension. Non-adherence may be intentional or unintentional. In the case of intentional non-adherence, it is crucial to understand the reasons behind it. The literature increasingly addresses the issue of beliefs and concerns about medication, but studies on this subject performed in a Polish population of hypertensive patients are still lacking. The aim of the study was to assess the level of intentional non-adherence among patients with hypertension, and to determine the relationship between beliefs about medication and the level of intentional non-adherence to treatment in elderly patients with hypertension. Material and methods: The study included 300 patients (106 of whom were male, mean age (SD) 71.71 (8.12) years) with hypertension, treated at a hypertension clinic. The following instruments were used: the Intentional Non-Adherence Scale (INAS) for evaluating intentional non-adherence, and the Beliefs about Medicines Questionnaire (BMQ) for evaluating patients’ beliefs and opinions regarding medication. Socio-demographic and clinical data were obtained from patients’ medical records. Results: The mean (SD) INAS score in the study was 47.28 (19.12). Patients were most concerned about the harm caused by medication, and least concerned about the necessity to take medication (mean score per item 3.49 vs. 2.14). Correlation analysis demonstrated weak correlations between BMQ and INAS: higher scores for necessity were associated with more intentional non-adherence (r = 0.174, p = 0.003), while higher scores for overuse, harm, and concerns were associated with less intentional non-adherence (respectively: r = −0.253, p < 0.001 vs. r = −0.336, p < 0.001 vs. r = −0.351, p < 0.001). In multiple-factor analysis, factors increasing the level of intentional non-adherence were elderly age (β = −0.352, p = 0.009), multimorbidity (β = −2.374, p = 0.035), and a higher BMQ concerns score (β = −1.376, p < 0.001), while being single was an independent predictor decreasing intentional non-adherence (β = 5.646, p = 0.013). Conclusions: The overall level of intentional non-adherence among patients with hypertension is moderate, but approximately one third of patients with hypertension demonstrate a high level of non-adherence. Independent determinants of intentional non-adherence include concerns, elderly age, multimorbidity, and being single.

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Section: Discussionmentioning

confidence: 99%

Impact of Beliefs about Medicines on the Level of Intentional Non-Adherence to the Recommendations of Elderly Patients with Hypertension

Świątoniowska-Lonc

Polański

Mazur

et al. 2021

IJERPH

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“…Unlike modification group I, this behavior suggests that medication is not adjusted as a response to recent changes in health such as improvement after a hospital stay or sudden adverse effects, but rather based on overall mistrust and concerns regarding medication. 34 , 36 …”

Section: Discussionmentioning

confidence: 99%

Identifying Patterns of Self-Reported Nonadherence Using Network Analysis in a Mixed German Cohort

Prell¹,

Franke²,

Jagla-Franke³

et al. 2022

PPA

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Purpose Nonadherence is a complex behaviour that contributes to poor health outcomes; therefore, it is necessary to understand its underlying structure. Network analysis is a novel approach to explore the relationship between multiple variables. Patients and Methods Patients from four different studies (N = 1.746) using the self-reported Stendal Adherence to Medication Score (SAMS) were pooled. Network analysis using EBICglasso followed by confirmatory factor analysis were performed to understand how different types of nonadherence covered in the SAMS items are related to each other. Results Network analysis revealed different categories of nonadherence: lack of knowledge about medication, forgetting to take medication, and intentional modification of medication. The intentional modification can further be sub-categorized into two groups, with one group modifying medication based on changes in health (improvement of health or adverse effects), whereas the second group adjusts medication based on overall medication beliefs and concerns. Adverse effects and taking too many medications were further identified as most influential variables in the network. Conclusion The differentiation between modification due to health changes and modification due to overall medication beliefs is crucial for intervention studies. Network analysis is a promising tool for further exploratory studies of adherence.

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“…6 Chronic conditions are often associated with low medication adherence rates. 1,3,7 It has been estimated that in the developed world only 50% of the persons with chronic disease take their medication as instructed. 8,9 Adherence rates in developing countries are believed to be much lower.…”

Section: Introductionmentioning

confidence: 99%

“…Medication adherence, which is the extent to which patients take their medication as prescribed and in agreement with their healthcare provider, is an important determinant of the safety and effectiveness of their therapy. 1 Optimal adherence is associated with improved health outcomes, such as reduced infectious disease transmission, reduced drug resistance, and lower healthcare utilization. 2 , 3 As many as 69% of medication-related hospital admissions are due to poor adherence.…”

Section: Introductionmentioning

confidence: 99%

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Development of a New Patient-Reported Medication Adherence Instrument: Concerns Influencing Medication Adherence

Mansukhani

MacLean

Manzey

et al. 2021

PPA

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The purpose of this research was to conceptualize and develop a tool for identifying persons who are, or are likely to be, non-adherent to medications prescribed by their healthcare provider(s) by identifying concerns that patients have regarding their treatments. Patients and Methods: The target populations were persons diagnosed with atrial fibrillation or osteoarthritis, who were prescribed anticoagulants or over-the-counter or prescription pain medications, respectively. In this two-stage, multi-year, qualitative research study, relevant concepts were explored, confirmed and refined. The focus was on non-adherence due to active (thus potentially modifiable) patient decisions to forego taking medications as prescribed. Results: The most common concerns among participants with atrial fibrillation were medication-related side effects and fear of bleeding. Participants with osteoarthritis were most concerned about short-term stomach problems and long-term kidney and liver side effects. The Concerns Influencing Medication Adherence (CIMA) instrument was developed based on these concerns and those identified in the literature. It is comprised of 16 items: a core set of 11 items potentially applicable to multiple disease states, 3 items specific to atrial fibrillation, and 2 items unique to osteoarthritis. The instrument is intended to be completed electronically, and publicly available for use in direct patient care in the United States or in population health management. Conclusion: To our knowledge, this is the first instrument focused on medication adherence that includes documented details of patient input as recommended by the United States Food and Drug Administration guidance. Patient input is considered a key component of content validity. In this research, for example, the concerns that patients have regarding their treatments can be expected to have affected past medication adherence and can potentially impact future adherence. Although applicability outside atrial fibrillation or osteoarthritis was not assessed, the general items may be useful in assessing adherence in other chronic diseases.

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<p>Different Associations of Intentional and Non-Intentional Non-Adherence Behaviors with Patient Experience with Healthcare and Patient Beliefs in Medications: A Survey of Patients with Chronic Conditions</p>

Cited by 15 publications

References 26 publications

Impact of Beliefs about Medicines on the Level of Intentional Non-Adherence to the Recommendations of Elderly Patients with Hypertension

Impact of Beliefs about Medicines on the Level of Intentional Non-Adherence to the Recommendations of Elderly Patients with Hypertension

Identifying Patterns of Self-Reported Nonadherence Using Network Analysis in a Mixed German Cohort

Development of a New Patient-Reported Medication Adherence Instrument: Concerns Influencing Medication Adherence

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