Impact of Treatment-Related Beliefs on Medication Adherence in Immune-Mediated Inflammatory Diseases: Results of the Global ALIGN Study

Abstract

IntroductionMedication adherence is critical in chronic immune-mediated inflammatory diseases (IMIDs) and could be affected by patients’ treatment-related beliefs. The objective of this study was to determine beliefs about systemic medications in patients with IMIDs and to explore the association of those beliefs and other factors with adherence.MethodsThis was a multi-country, cross-sectional, self-administered survey study. Included were adults diagnosed with one of six IMIDs receiving conventional systemic medications and/or tumor necrosis factor inhibitors (TNFi). Patients’ necessity beliefs/concerns towards and adherence to treatments were assessed by the Beliefs about Medicines Questionnaire and four-item Morisky Medication Adherence Scale. Correlation of patients’ beliefs about treatment and other factors with adherence were evaluated by multivariable regression analyses.ResultsAmong studied patients (N = 7197), 32.0% received TNFi monotherapy, 27.7% received TNFi–conventional combination therapy, and 40.3% received conventional medications. Across IMIDs, high adherence to systemic treatment was more prevalent in TNFi groups (61.3–80.7%) versus corresponding conventional treatment groups (28.4–64.7%). In at least four IMIDs, greater perception of the illness continuing forever (P < 0.001), of the treatment helping (P < 0.001), and more concerns about the illness (P < 0.01), but not clinical parameters, were associated with higher treatment necessity beliefs. Higher treatment necessity beliefs, older age, Caucasian race, and TNFi therapy were associated with high medication adherence in at least four IMIDs.ConclusionsTreatment necessity beliefs were higher than concerns about current medication in patients with IMID. Illness perceptions had a greater impact on treatment necessity beliefs than clinical parameters. Older age, greater treatment necessity beliefs, and TNFi therapy were associated with high self-reported medication adherence in at least four IMIDs.Trial registrationACTRN12612000977875.FundingAbbVie.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-016-0441-3) contains supplementary material, which is available to authorized users.

Prevalence and Associated Factors for Non-adherence in Patients with Rheumatoid Arthritis

“…Among the questionnaires, we selected more objective questions that asked the number of days the patient failed to take their medication, and defined non-adherence failure to take medication 6 days or more. Compared to previous studies, the adherence rate of 90.4% is quite high [9][10][11][12][13][14][15][16][17][18][20][21][22][23][24][25][26][27][28][29]. We assumed that this result was due to the characteristics of the patient cohort rather than our method of estimation.…”

ALIGNed on adherence: subanalysis of adherence in immune‐mediated inflammatory diseases in the DACH region of the global ALIGN study

“…Adherence to therapy is a central factor for controlling a disease. Within the global ALIGN study, the DACH region was analysed to determine general and specific beliefs towards medication and treatment adherence in patients simultaneously in different IMIDs …”

“…Secondary objectives were to define patients’ beliefs and adherence about systemic medications and distribution of adherence among different IMIDs. Herein, the data for the DACH region (Deutschland = Germany, Austria, Confoederatio Helvetica = Switzerland) from the global ALIGN data were analysed …”

“…Herein, the data for the DACH region (Deutschland = Germany, Austria, Confoederatio Helvetica = Switzerland) from the global ALIGN data were analysed. 10 Hence, identifying the reasons for non-adherence in patients with IMIDs is of paramount importance to generate tools and educational programs. Additionally, a practical tool with communication strategies for different patient types was developed.…”

Do treatment patterns alter beliefs cancer patients hold regarding oral oncolytic agents?

“…The Beliefs about Medicines Questionnaire (BMQ) is grounded in social cognition as expressed through the health belief model and assesses patients' positive outcome expectancy (benefits from treatment) and the accompanying concerns regarding the use of medications and their interference with daily activities . Patients' scores on the necessity and concerns subscales have been found to be associated with their levels of adherence as well as with their sex, symptom reports, duration of treatment, number of medications, and depression …”