Xiaoxia Qiao1, Xiaoyu Tian2, Na Liu3, Lijuan Dong4, Yaru Jin5, Huaxin Si6, Xinyi Liu7, Cuili Wang8. 1. School of Nursing, Peking University, 100191, Beijing, China. Electronic address: qiaoxiaoxia2009@163.com. 2. School of Nursing, Shandong University, 250012, Jinan, China. Electronic address: 1134074780@qq.com. 3. School of Nursing, Shandong University, 250012, Jinan, China. Electronic address: liuna_5015358@163.com. 4. School of Nursing, Shandong University, 250012, Jinan, China. Electronic address: donglijuan_89@163.com. 5. School of Nursing, Peking University, 100191, Beijing, China. Electronic address: 476938129@qq.com. 6. School of Nursing, Peking University, 100191, Beijing, China. Electronic address: 1138226925@qq.com. 7. School of Nursing, Shandong University, 250012, Jinan, China. Electronic address: 596973003@qq.com. 8. School of Nursing, Peking University, 100191, Beijing, China. Electronic address: cwangpk@163.com.
Abstract
OBJECTIVE: To explore the association between frailty and medication adherence by modeling medication beliefs (i.e., necessity and concerns) as mediators among community-dwelling older patients. METHODS: This cross-sectional study was conducted among 780 Chinese older patients. Frailty, medication adherence and medication beliefs were assessed using the Comprehensive Frailty Assessment Instrument (CFAI), the 4-item Morisky Medication Adherence Scale (MMAS-4) and the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific), respectively. The PROCESS SPSS Macro version 2.16.3, model 4 was used to test the significance of the indirect effects. RESULTS: Frailty was associated with high medication necessity (β = 0.091, p = 0.011) and high medication concerns (β = 0.297, p < 0.001). Medication adherence was positively associated with medication necessity (β = 0.129, p = 0.001), and negatively associated with medication concerns (β = -0.203, p < 0.001). Medication necessity and medication concerns attenuated the total effect of frailty on medication adherence by -13.6% and 70.3%, respectively CONCLUSION: High medication concerns among frail older patients inhibit their medication adherence, which cannot be offset by the positive effect of their high medication necessity on medication adherence. PRACTICE IMPLICATIONS: Interventions should target medication beliefs among frail older patients, particularly medication concerns, to efficiently improve their medication adherence.
OBJECTIVE: To explore the association between frailty and medication adherence by modeling medication beliefs (i.e., necessity and concerns) as mediators among community-dwelling older patients. METHODS: This cross-sectional study was conducted among 780 Chinese older patients. Frailty, medication adherence and medication beliefs were assessed using the Comprehensive Frailty Assessment Instrument (CFAI), the 4-item Morisky Medication Adherence Scale (MMAS-4) and the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific), respectively. The PROCESS SPSS Macro version 2.16.3, model 4 was used to test the significance of the indirect effects. RESULTS: Frailty was associated with high medication necessity (β = 0.091, p = 0.011) and high medication concerns (β = 0.297, p < 0.001). Medication adherence was positively associated with medication necessity (β = 0.129, p = 0.001), and negatively associated with medication concerns (β = -0.203, p < 0.001). Medication necessity and medication concerns attenuated the total effect of frailty on medication adherence by -13.6% and 70.3%, respectively CONCLUSION: High medication concerns among frail older patients inhibit their medication adherence, which cannot be offset by the positive effect of their high medication necessity on medication adherence. PRACTICE IMPLICATIONS: Interventions should target medication beliefs among frail older patients, particularly medication concerns, to efficiently improve their medication adherence.