Intentionality of medication non-adherence among individuals living with HIV/AIDS in Hong Kong

Mo, Phoenix K. H.; Mak, Winnie W. S.

doi:10.1080/09540120802511968

Cited by 37 publications

(31 citation statements)

References 65 publications

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“…Intentional nonadherence includes an active decision-making process to disregard professional advice, whereas unintentional or inadvertent nonadherence involves a passive process which is less strongly associated with beliefs and cognitions [92,94]. Only one study in the present review differentiated between these two types of nonadherence and found differential associations with stigma [55]. Clarifying differences in intentional and unintentional nonadherence will be critical in understanding the role of HIV-related stigma as a barrier to adherence.…”

Section: Medication Adherencementioning

confidence: 85%

“…In Dlamini et al's investigation with PLWH in five African countries, participants who were adherent had lower stigma scores at baseline and experienced a steeper decline in stigma over time than participants who were non-adherent [54]. Additionally, in a sample of Chinese PLWH, Mo and Mak demonstrated that higher stigma scores at baseline predicted intentional nonadherence, compared to adherence and unintentional nonadherence, at 6-month follow up [55].…”

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 88%

“…The most frequently used measure was an original or modified version of Berger's HIV Stigma Scale [46][47][48][49][50][51], which includes four subscales of personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. In other investigations, stigma was assessed through a variety of instruments including the HIV Internalized Stigma Measure [52,53], HIV/AIDS Stigma Instrument-PLWA [54], Self-Stigma Scale [55], HIV/AIDS-related Stigma and Discrimination [56], Stigma Scale for Chronic Illness [57], and items selected from the Patient Medication Adherence Questionnaire [52]. These instruments are characterized by a range of subconstructs, including internalized (e.g., negative self-perception), anticipated (e.g., renegotiating social relationships), and enacted (e.g., healthcare discrimination) stigmas.…”

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 99%

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The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

2015

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This paper provides a review of the quantitative literature on HIV-related stigma and medication adherence, including: (1) synthesis of the empirical evidence linking stigma to adherence, (2) examination of proposed causal mechanisms of the stigma and adherence relationship, and (3) methodological critique and guidance for future research. We reviewed 38 studies reporting either cross-sectional or prospective analyses of the association of HIV-related stigma to medication adherence since the introduction of antiretroviral therapies (ART). Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provided data on psychosocial mechanisms that may account for this relationship. Proposed mechanisms include: (a) enhanced vulnerability to mental health difficulties, (b) reduction in self-efficacy, and (c) concerns about inadvertent disclosure of HIV status. Future research should strive to assess the multiple domains of stigma, use standardized measures of adherence, and include prospective analyses to test mediating variables.

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Section: Medication Adherencementioning

confidence: 85%

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 88%

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 99%

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The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

2015

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“…Both intentional and unintentional nonadherence has been studied in patients with chronic illness including: asthma, lupus, hypertension, and breast cancer (Atkins & Fallowfield, 2006; Daleboudt, Broadbent, McQueen & Kaptein, 2010; Lehane & McCarthey, 2007; Lowry, Dudley, Oddone & Bosworkth, 2005; Wroe, 2002). This area of study has been limited in PLWHA (Mo & Mak, 2009; Norton et al, 2010; Wroe & Thomas, 2003). Mo and Mak (2009) investigated factors associated with adherence, intentional nonadherence, and unintentional nonadherence among PLWHA in Hong Kong.…”

Section: Intentional and Unintentional Adherencementioning

confidence: 99%

Appreciating Reasons for Nonadherence in Women

Okonsky

Webel

Rose

et al. 2014

Health Care for Women International

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Women aged 15–24 years have an HIV infection rate twice that of men the same age. This study examined reasons why HIV-infected women taking antiretroviral therapy (ART) report missing HIV medications. Women (N= 206) on ART were 2.2 times more likely to endorse reasons pertaining to forgetfulness versus reasons pertaining to problems taking pills (OR= 2.2, 95% CI: 1.63, 2.94, p<0.001). There was a difference between the adherent and non-adherent groups in types of reasons overall, (p<. 001, 95%CI −3.82, −2.03). Using a patient-centered approach to understand type of nonadherence (intentional vs. unintentional) may support development of novel interventions.

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“…214 As discussed in Section 1.4, patients are non-adherent due to many different reasons, and may be subjected to different types of non-adherence concurrently (Section 1.2.4). 1,18,87,89,90,93,96,100,114,115,145,147 Both are important to consider when selecting an appropriate intervention to address non-adherence. 33 Identifying the reasons for nonadherence facilitates a strategy to address these reasons, which can be described as a tailored intervention.…”

Section: Self-report Adherence Scalesmentioning

confidence: 99%

Improving medication adherence in patients with chronic disease using a targeted and tailored approach

Nguyen¹

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Improving adherence to medications is an opportunity that can yield great improvements in health outcomes and reducing health costs. Supporting adherence to medicines requires insight into a patient's medication-taking behaviour and their reasons for non-adherence.Adherence interventions that show most promise include multifaceted interventions, and those targeted to non-adherent patients and/or tailored to patient-specific reasons for nonadherence. To identify non-adherent patients and their reasons for non-adherence in the practice setting, I argue that we require inexpensive measures that are easy to use and can inform the discussion with patients about their adherence. Adherence scales are inexpensive, easy-to-administer and have the potential to explore both medication-taking behaviour and reasons for behaviour.The overall aim of the thesis is to determine if a targeted and tailored intervention based on a discussion informed by validated adherence scales, will improve adherence to a recently initiated cardiovascular medication. I hypothesise that targeting and tailoring an intervention to non-adherent participants based on a discussion informed by adherence scales, will improve adherence at three months as measured by the four-item Medication Adherence Questionnaire (MAQ). I will also test whether improvements in adherence at three months are sustained at six months and explore the changes in adherence and reasons for nonadherence over time.The first part of the thesis involved identifying validated adherence scales suitable for use in the intervention. A systematic review was conducted on adherence scales to explore their use and validation. We found that adherence scales measured different aspects of adherence: medication-taking behaviour, barriers to adherence and beliefs associated with adherence. Adherence scales have been validated in different disease populations and against different measures of adherence. We selected two adherence scales for our study: the MAQ and Beliefs about Medicines Questionnaire-Specific (BMQ-S). The MAQ is one of the most commonly used adherence scales that has been validated in many disease populations and against different measures of adherence including electronic monitoring.The BMQ-S has been extensively used to elicit medication beliefs associated with medication adherence and validated in a number of diseases including cardiovascular disease, asthma and depression.A randomised controlled trial was conducted to determine if a targeted and tailored intervention would improve medication adherence. Four hundred and eight patients were iii assessed for eligibility from two community pharmacies, from which 152 patients were enrolled into the study. All enrolled participants completed the MAQ, BMQ-S and Brief Illness Perceptions Questionnaire (BIPQ). There were 120 participants identified as non-adherent using the MAQ, who were randomised into an intervention or control group. The remaining 32 participants were identified as adherent. In the intervention group, the r...

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Intentionality of medication non-adherence among individuals living with HIV/AIDS in Hong Kong

Cited by 37 publications

References 65 publications

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

Appreciating Reasons for Nonadherence in Women

Improving medication adherence in patients with chronic disease using a targeted and tailored approach

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