Relationships between beliefs about medications and adherence
ABSTRACT The relationships between beliefs about medications, health literacy, and self-reported medication adherence are examined.
Patients from an inner-city hospital pharmacy completed an in-person, interviewer-assisted questionnaire that included the Morisky 8-item Medication Adherence Scale (MMAS-8), the Beliefs About Medicines Questionnaire (BMQ), and the Rapid Estimate of Adult Literacy in Medicine (REALM). Multivariable logistic regression was used to determine predictors of self-reported medication adherence as determined by the MMAS-8. Variables included in the model were summary scores from the BMQ, REALM, and patient or regimen characteristics that were significantly associated with the MMAS-8.
A majority of the 275 study participants were African-American (86.2%), were women (73.1%), and could read at less than a high school reading level (59.7%). The average age was 53.9 years. Approximately half of the patients (52.7%) reported low medication adherence (MMAS-8 score of >2). Multivariate analyses indicated several factors were associated with low self-reported adherence, including negative beliefs about medications, younger age, low medication self-efficacy, and hyperlipidemia. Health literacy was not independently associated with beliefs or adherence.
Patients who had negative beliefs about medications, who were <65 years of age, or who had low medication self-efficacy reported low medication adherence.
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ABSTRACT: There are gaps in research regarding medication adherence, self-efficacy in proper medication adherence, and health literacy among breast cancer survivors. This pilot randomized controlled study was conducted to provide information addressing health literacy with respect to medication adherence and self-efficacy in African American breast cancer survivors. The study sample consisted of an intervention group (n = 24) of medication adherence skills training (MST) and a control group (n = 24), with a total sample population of 48 participants. The MST workshop was a collaborative intervention between pharmacy and social work and was designed to address issues that may be encountered while taking multiple medications for various acute and chronic conditions, increase participant confidence in accessing necessary resources for improved medication usage, and enhance personal self-efficacy regarding health care. A statistically significant relationship was detected between initial health literacy and medication adherence, as well as initial health literacy and self-efficacy. These findings indicated that individuals with higher health literacy were more likely to have higher levels of self-efficacy and were more likely to adhere to medication instructions. Analysis of the intervention and treatment groups did not show a statistically significant effect on health literacy, medication adherence, or self-efficacy from pre-test to post-test.Social Work in Health Care 01/2015; 54(1):33-46. DOI:10.1080/00981389.2014.964447 · 0.62 Impact Factor
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ABSTRACT: Medication non-adherence is a major challenge in the real-life treatment of chronically ill patients. To meet this challenge, adherence interventions with a tailored approach towards patient-specific adherence barriers that are identified with a reliable and practicable questionnaire are needed. The aim of this investigation was to develop and validate such a questionnaire, the "Adherence Barriers Questionnaire (ABQ)". The German ABQ was developed and tested in 432 patients with atrial fibrillation in a multicentre observational cohort study. Evaluation of the questionnaire included an assessment of internal consistency as well as factor analysis. Criterion-related external validity was assessed by comparing the ABQ score with (1) the degree of self-reported adherence and (2) the time in therapeutic range which describes the anticoagulation quality achieved by patients treated with oral anticoagulation. The final 14-item ABQ scale demonstrated high internal consistency (Cronbach's alpha = 0.820). Factor analysis identified a three-factor solution, representing intentional adherence barriers with 5 items (31.9% of the variance), medication-/health care system-related adherence barriers with 5 items (13.3% of the variance) and unintentional adherence barriers with 4 items (7.7% of the variance). The ABQ correlated significantly with self-reported non-adherence (Spearman's rho = 0.438, p < 0.001) as well as time in therapeutic range (Spearman's rho = - 0.161, p < 0.010). Patients with above-average ABQ scores (increased number and/or strength of existing adherence barriers) were significantly (p < 0.005, Pearson Chi-Square) more likely to have a poor anticoagulation quality (TTR < 60%) than patients with a lower ABQ score (44.6% versus 27.3%). The ABQ is a practicable, reliable and valid instrument for identifying patient-specific barriers to medication-related adherence. Future research is required to examine the ability of the ABQ to identify patient perception/behaviour changes over time which may be important for the measurement of success of adherence interventions.BMC Health Services Research 04/2015; 15(1):153. DOI:10.1186/s12913-015-0809-0 · 1.66 Impact Factor
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ABSTRACT: The phenomenon of adherence to treatment is a motive of worry from the scientific community, since it is considered as a worldwide problem of high magnitude. The implications are of great relevance in morbidity, mortality, in the significant increase in the consumption of health care and in the costs to the health system, particularly in patients with ischemic heart disease. We intend to evaluate adherence to treatment and relate beliefs about medicines with adherence to treatment. This study is descriptive-correlational and cross-sectional. It was performed on 254 patients with ischemic heart disease who were in follow-up consultation in the hospital at the time of the questionnaire application. Data collection was performed through a self-administered questionnaire, integrating the following scales: Measure Adherence to Treatment and Beliefs about Medicines Questionnaire. The patients had a mean age of 66.94 years (SD=11.62), 74% were male, 73.2% were married, 69.3% had education up to the "4th grade", 57.1% lived in the village, 70.1% were retired and 49.6% had an income below "one minimum wage". We found that 50.4% of patients did not adhere to treatment. Women had a strong belief in the specific needs of the prescribed medication, while men expressed greater belief in relation to long-term side effects (P>.05). Patients who expressed a low belief about the harmful potential of medicines revealed predictors of adherence to medication. The results are consistent with previous studies in which individuals with lower beliefs in specific concerns reported higher rates of adherence to medication. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.Atención Primaria 11/2014; 46 Suppl 5:101-6. DOI:10.1016/S0212-6567(14)70074-5 · 0.89 Impact Factor