‘A necessary evil’: associations with taking medication and their relationship with medication adherence

Kleppe, Mieke; Lacroix, Jpw Joyca; Ham, Jaap; Midden, Cjh Cees

doi:10.1080/13548506.2017.1316412

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…In a study aimed at investigating the first associations, patients had with taking their medication and whether these associations were related to adherence behaviour, the highest mean adherence rates were found for participants reporting “necessity” followed by “routine”. Their study found that negative associations reported were mostly of an emotional nature, whereas positive associations were mostly of a cognitive nature (Kleppe et al., 2017 ). This confirms the necessity of involving the patient in their own care, for us to listen to their feelings regarding medication and for patients to process what the treatment entails.…”

Section: Discussionmentioning

confidence: 99%

Treated with preventive anticoagulation therapy in atrial fibrillation: The patients’ perspective

2021

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Atrial fibrillation (AF) is a common arrhythmia in adults, which increases the risk for stroke (Pistoia et al., 2016). The prevalence of AF in adults is 2%-4%, and the disease is expected to increase in prevalence (Hindricks et al., 2020). It is estimated that in year 2030 about 14-17 million people in Europe will have AF. One important cornerstone in the management of AF is thrombosis prophylaxis with oral anticoagulant therapy (OAC), with vitamin K antagonists (VKA) or non-VKA oral anticoagulants (NOAC). VKAs have for a long time been the only treatment for thromboembolic diseases but nowadays NOAC is an increasingly common treatment alternative (Kirchhof, Benussi, et al., 2016). Both treatments can be complicated because they increase the risk of bleeding, but one difference with warfarin is that it requires frequent blood tests and dosage adjustments (Salmasi et al., 2019). | INTRODUC TI ONOral anticoagulant treatment reduces stroke and mortality in AF patients, but despite the evidence for OACs to reduce the risk for stroke, some patients stop taking their medications (Hindricks et al., 2020;Kirchhof, Benussi, et al., 2016). Reasons for not taking OAKs are reported to be lack of knowledge about the purpose of the therapy, the risk of bleeding complications or the effort required from the patient to verify or adjust the dose of VKA (Kirchhof,

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Section: Discussionmentioning

confidence: 99%

Treated with preventive anticoagulation therapy in atrial fibrillation: The patients’ perspective

2021

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“…This study was approved by the Internal Committee Biomedical Experiments of Philips Research. It was part of a larger investigation (see Kleppe et al, in press).…”

Section: Methodsmentioning

confidence: 99%

A dual-process view on medication adherence: The role of affect

et al. 2017

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Medication non-adherence has been recognised as one of the major problems in health care that leads to preventable costs and hospitalisations. This study aimed to assess the role of affect in medication adherence. We propose a dual-process framework of medication adherence based on the reflective-impulsive model, which includes both cognitive and affective processes. We tested this framework in a cross-sectional study ( N = 525). The results supported this framework by illustrating the clear role of both cognitive and affective processes.

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“…The barrier questionnaire was developed and validated in an earlier study (data not shown). First, a list of 25 adherence determinants was composed, based on existing evidence in the literature about their relationship with medication nonadherence [8,[23][24][25][26][27]. Second, an extensive questionnaire was composed by assessing this list of 25 determinants making use of existing (shorter versions of) instruments for the constructs for which they existed and self-composed items when instruments did not exist.…”

Section: Patient Questionnairementioning

confidence: 99%

Effectiveness of a Pharmacist-Led Web-Based Medication Adherence Tool With Patient-Centered Communication: Results of a Clustered Randomized Controlled Trial

Lieshout¹,

Lacroix²,

Halteren³

et al. 2022

J Med Internet Res

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Background Growing numbers of people use medication for chronic conditions; nonadherence is common, leading to poor disease control. A web-based tool to identify an increased risk for nonadherence with related potential individual barriers might facilitate tailored interventions and improve adherence. Objective This study aims to assess the effectiveness of a newly developed tool aimed at improving medication adherence. Methods We performed a cluster randomized controlled trial in patients initiating cardiovascular or oral blood glucose–lowering medication. Participants were recruited from community pharmacies. They completed an online questionnaire comprising assessments of their risk for medication nonadherence and subsequently of barriers to adherence. In pharmacies belonging to the intervention group, individual barriers displayed in a graphical profile on a tablet were discussed by pharmacists and patients with high nonadherence risk in face-to-face meetings and shared with their general practitioners and practice nurses. Tailored interventions were initiated by pharmacists. Barriers of control patients were not presented nor discussed and these patients received usual care. The primary outcome was the effectiveness of the intervention on medication adherence at 8 months’ follow-up between patients with an increased nonadherence risk from the intervention and control groups, calculated from dispensing data. Results Data from 492 participants in 15 community pharmacies were available for analyses (intervention 253, 7 pharmacies; control 239, 8 pharmacies). The intervention had no effect on medication adherence (B=–0.01; 95% CI –0.59 to 0.57; P=.96), nor in the post hoc per-protocol analysis (B=0.19; 95% CI –0.50 to 0.89; P=.58). Conclusions This study showed no effectiveness of a risk stratification and tailored intervention addressing personal barriers for medication adherence. Various potential explanations for lack of effectiveness were identified. These explanations relate, for instance, to high medication adherence in the control group, study power, and fidelity. Process evaluation should elicit possible improvements and inform the redesign of intervention and implementation. Trial Registration The Netherlands National Trial Register NTR5186; https://tinyurl.com/5d8w99hk

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‘A necessary evil’: associations with taking medication and their relationship with medication adherence

Cited by 9 publications

References 16 publications

Treated with preventive anticoagulation therapy in atrial fibrillation: The patients’ perspective

Treated with preventive anticoagulation therapy in atrial fibrillation: The patients’ perspective

A dual-process view on medication adherence: The role of affect

Effectiveness of a Pharmacist-Led Web-Based Medication Adherence Tool With Patient-Centered Communication: Results of a Clustered Randomized Controlled Trial

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