Sieta T de Vries1, Joost C Keers2, Rosalie Visser3, Dick de Zeeuw4, Flora M Haaijer-Ruskamp5, Jaco Voorham6, Petra Denig7. 1. Department of Clinical Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: s.t.de.vries@umcg.nl. 2. Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Van Swieten Research Institute, Martini Hospital, Groningen, The Netherlands. Electronic address: j.keers@mzh.nl. 3. Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, The LifeLines Cohort Study, Groningen, The Netherlands. Electronic address: r.visser02@umcg.nl. 4. Department of Clinical Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: d.de.zeeuw@umcg.nl. 5. Department of Clinical Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: f.m.haaijer-ruskamp@umcg.nl. 6. Department of Clinical Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: j.voorham01@umcg.nl. 7. Department of Clinical Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: p.denig@umcg.nl.
Abstract
OBJECTIVE: To assess the relationship of patients' medication beliefs and treatment complexity with unintentional and intentional non-adherence for three therapeutic groups commonly used by patients with type 2 diabetes. METHODS: Survey data about adherence (Medication Adherence Report Scale) and beliefs about medicines (Beliefs about Medicines Questionnaire) were combined with prescription data from the Groningen Initiative to ANalyse Type 2 diabetes Treatment (GIANTT) database. Patients were classified as being adherent, mainly unintentional non-adherent, or partly intentional non-adherent per therapeutic group (glucose-, blood pressure-, and lipid-lowering drugs). Treatment complexity was measured using the Medication Regimen Complexity Index, which includes the dosage form, dosing frequency and additional directions of taking the drug. Analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests. RESULTS: Of 257 contacted patients, 133 (52%) returned the questionnaire. The patients had a mean age of 66years and 50% were females. Necessity beliefs were not significantly different between the adherers, mainly unintentional non-adherers, and partly intentional non-adherers (differences smaller than 5 points on a scale from 5 to 25). For blood pressure-lowering drugs, patients reporting intentional non-adherence had higher concern beliefs than adherers (8 point difference, P=0.01). Treatment complexity scores were lower for adherers but similar for mainly unintentional and partly intentional non-adherers to glucose- and blood pressure-lowering drugs. CONCLUSION: Treatment complexity was related to non-adherence in general. Beliefs about necessity were not strongly associated with non-adherence, while patients' concern beliefs may be associated with intentional non-adherence. However, the role of these determinants differs per therapeutic group.
OBJECTIVE: To assess the relationship of patients' medication beliefs and treatment complexity with unintentional and intentional non-adherence for three therapeutic groups commonly used by patients with type 2 diabetes. METHODS: Survey data about adherence (Medication Adherence Report Scale) and beliefs about medicines (Beliefs about Medicines Questionnaire) were combined with prescription data from the Groningen Initiative to ANalyse Type 2 diabetes Treatment (GIANTT) database. Patients were classified as being adherent, mainly unintentional non-adherent, or partly intentional non-adherent per therapeutic group (glucose-, blood pressure-, and lipid-lowering drugs). Treatment complexity was measured using the Medication Regimen Complexity Index, which includes the dosage form, dosing frequency and additional directions of taking the drug. Analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests. RESULTS: Of 257 contacted patients, 133 (52%) returned the questionnaire. The patients had a mean age of 66years and 50% were females. Necessity beliefs were not significantly different between the adherers, mainly unintentional non-adherers, and partly intentional non-adherers (differences smaller than 5 points on a scale from 5 to 25). For blood pressure-lowering drugs, patients reporting intentional non-adherence had higher concern beliefs than adherers (8 point difference, P=0.01). Treatment complexity scores were lower for adherers but similar for mainly unintentional and partly intentional non-adherers to glucose- and blood pressure-lowering drugs. CONCLUSION: Treatment complexity was related to non-adherence in general. Beliefs about necessity were not strongly associated with non-adherence, while patients' concern beliefs may be associated with intentional non-adherence. However, the role of these determinants differs per therapeutic group.
Authors: Grace E McInerney; Kimberly Muellers; Rachel O'Conor; Michael S Wolf; Howard Leventhal; Juan P Wisnivesky; Alex D Federman Journal: Patient Educ Couns Date: 2019-11-16
Authors: Alejandra Soto; Ximena Avila; Pia Cordova; Pola Fernandez; Mariela Lopez; Lorenzo A Villa; Felipe Morales Journal: Int J Clin Pharm Date: 2015-05-26
Authors: Anastasia-Stefania Alexopoulos; William S Yancy; David Edelman; Cynthia J Coffman; Amy S Jeffreys; Matthew L Maciejewski; Corrine I Voils; Nicole Sagalla; Anna Barton Bradley; Moahad Dar; Stéphanie B Mayer; Matthew J Crowley Journal: Chronic Illn Date: 2019-10-25
Authors: Jason R Hodges; Shannon M Phillips; Sarah Norell; Chinonyelum Nwosu; Hamda Khan; Lingzi Luo; Sherif M Badawy; Allison King; Paula Tanabe; Marsha Treadwell; Lucia Rojas Smith; Cecelia Calhoun; Jane S Hankins; Jerlym Porter Journal: Blood Adv Date: 2020-09-22
Authors: Barbara Caecilia Wimmer; Kristina Johnell; Johan Fastbom; Michael David Wiese; J Simon Bell Journal: Eur J Clin Pharmacol Date: 2015-06-14 Impact factor: 2.953
Authors: Marine Solano; Etienne Daguindau; Cyril Faure; Pierre Loriod; Coline Pain; Anne-Cécile Maes; Pauline Marguet; Marie Kroemer; Anne Rumpler; Jean Fontan; Eric Deconinck; Samuel Limat; Anne-Laure Clairet Journal: Ann Hematol Date: 2021-05-03 Impact factor: 3.673
Authors: Jennifer B Levin; Anna Krivenko; Ashley Bukach; Curtis Tatsuoka; Kristin A Cassidy; Martha Sajatovic Journal: J Nerv Ment Dis Date: 2017-03 Impact factor: 2.254