Medication Adherence and Coping with Disease in Patients from a Neurological Clinic: An Observational Study

Franke, Gabriele Helga; Nentzl, Julia; Jagla-Franke, Melanie; Prell, Tino

doi:10.2147/ppa.s311946

Cited by 9 publications

(12 citation statements)

References 54 publications

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“…One if its advantages is that different facets of adherence are included, namely modification of medication, lack of knowledge and forgetting to take medication 18 22. The SAMS has previously been validated in neurological patients, patients with chronic pain and patients with kidney transplants, and has been used in a variety of studies since 18 23–27…”

Section: Methodsmentioning

confidence: 99%

Using a generic quality of life measure to determine adherence thresholds: a cross-sectional study on older adults with neurological disorders in Germany

2023

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ObjectivesMeasuring the degree of adherence to medication is essential in healthcare However, the cut-offs provided for adherence scales are often arbitrary and disease-specific, and need to be validated against a clinical outcome. Here, we used health-related quality of life (QoL) to determine cut-offs for a self-report adherence questionnaire in patients with neurological diagnoses.DesignCross-sectional study.Participants910 patients (age 70±8.6 years) with neurological disorders were recruited from the wards of neurology at a local university hospital. All patients received a comprehensive geriatric assessment, including assessments of adherence (Stendal Adherence to Medication Score, SAMS) and QoL (Short Form Survey SF-36).Outcome measuresThe main aim of the study was to define a cut-off for non-adherence at which QoL is significantly impaired. Thus, we used Spearman’s rank correlation, multivariate and univariate analyses of variance to test the impact of different adherence levels on QoL. Receiver operating characteristics and area under curve measures were then used to determine cut-off scores for adherence based on significant differences in QoL.ResultsCorrelations between SAMS and SF-36 domains were weak (ranging between r=−0.205 for emotional well-being and r=−0.094 for pain) and the effect of non-adherence on QoL disappeared in the multivariate analysis of variance (p=0.522) after adjusting for demographical and clinical factors. SAMS cut-offs in terms of SF-36 domains varied greatly, so that an overall SAMS cut-off for this cohort could not be defined.ConclusionsQoL as measured by the SF-36 is not suitable as a single outcome parameter to study the impact of non-adherence on QoL in a mixed neurological cohort. Since both QoL and adherence are heterogeneous, multifaceted constructs, it is unlikely to find an overarching cut-off applicable for all patients. Thus, it may be necessary to use disease or cohort-specific external outcome parameters to measure the indirect effect of interventions to enhance adherence.Trial registration numberDRKS00016774.

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Section: Methodsmentioning

confidence: 99%

Using a generic quality of life measure to determine adherence thresholds: a cross-sectional study on older adults with neurological disorders in Germany

2023

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“…Persönlichkeit wurde mit dem NEO-FFI-25 21 erfasst. Dieses ökonomische Verfahren basiert auf den jeweils fünf ladungsstärksten Items der Big-Five-Persönlichkeitseigenschaften Neurotizismus, Extraversion, Offenheit, Verträglichkeit und Gewissenhaftigkeit aus dem deutschen NEO-FFI Persönlichkeitsinventar 22 .…”

Section: Materials Und Methodenunclassified

“… Anmerkungen. a p -Werte mit Bonferroni-Holm Korrektur; b Screeningverfahren zur Erhebung von kompensatorischem und süchtigem Kaufverhalten 5 ; c NEO Fünf-Faktoren-Inventar-25 21 ; d Material Value Scale – German Version 23 ; e Mini Symptom-Checklist 24 ; f Liste zur Auswahl präferierter Produkte 26] * p <0,05; ** p <0,01; *** p <0,001. …”

Section: Ergebnisseunclassified

“…Unauffällig Konsumierende zeigten sich verträglicher als Selbstregulationskonsumierende. Verträglichkeit kann ein Schutzfaktor für SK sein 9 10 , da diese Personen Konflikte vermeiden und nach Harmonie streben 21 , was im Widerspruch zu interpersonell konfliktreichen Verhaltenssüchten steht 5 . Für Offenheit und SK zeigte sich in der Literatur kein Zusammenhang 9 10 .…”

Section: Diskussionunclassified

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Muster von problematischem Kaufverhalten unter Studierenden und deren Unterschiede in Persönlichkeitsmerkmalen, materieller Werteorientierung, psychischer Belastung und Produktpräferenz

2023

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Zusammenfassung Ziel der Studie ist, zu einem differenzierten Verständnis von Kaufsucht beizutragen, indem untersucht wird, inwieweit problematisches Kaufverhalten als mehrdimensionales Konstrukt zu verstehen ist. Um Fachkräfte in Prävention und Unterstützung von Betroffenen zu sensibilisieren, werden verschiedene Personengruppen mit problematischem Kaufverhalten voneinander abgegrenzt. Methodik Es wurden N=258 Studierende zu Kaufverhalten und Persönlichkeitsmerkmalen, materieller Werteorientierung, psychischer Belastung sowie Produktpräferenzen befragt. Die Dimensionalität des problematischen Kaufverhaltens wurde faktorenanalytisch geprüft und bildet die Grundlage für nachgeschaltete Cluster- und Diskriminanz- sowie Varianzanalysen zur Differenzierung verschiedener Personengruppen mit problematischem Kaufverhalten. Ergebnisse Problematisches Kaufverhalten setzt sich aus fehlender Bedarfsorientierung, impulsiv-reaktivem Verhalten und selbstregulatorisch-reflektierter Tendenz zusammen. Es zeigten sich die zwei Subtypen Status- sowie Selbstregulationskonsumierende, die sich im Ausmaß ihrer Somatisierung unterscheiden. Auffällig Konsumierende hatten im Vergleich zu Personen mit unauffälligem Kaufverhalten eine höhere materielle Werteorientierung und einen höheren Neurotizismuswert. Verglichen mit gewöhnlichen Konsumierenden waren Selbstregulationskonsumierende weniger offen und verträglich, stärker psychisch belastet und hatten mehr Produktpräferenzen. Schlussfolgerung Problematisches Kaufverhalten sollte zukünftig in Bezug auf fehlende Bedarfsorientierung, impulsiv-reaktives Verhalten und selbstregulatorisch-reflektierte Tendenz differenzierter klassifiziert und diagnostiziert werden. Neurotizismus, materielle Werteorientierung sowie zugrundeliegende Kaufmotive, wie die Aufwertung von Status und Identität oder die Regulation von aversiven Emotionen, könnten eine bedeutende Rolle in Prävention und Behandlung von problematischem Kaufverhalten spielen.

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“…The 18 SAMS items can be assigned to three different factors: 1) modification of medication , ie intentionally changing dosages or leaving medications out, 2) lack of knowledge about medication , and 3) forgetting to take medication . 7 , 12 , 13 Modification refers to intentional changes in medication made without consulting the treating physicians. Lack of knowledge refers to missing knowledge about one’s own medication (eg reasons for prescription and effect, time-point, dosage).…”

Section: Introductionmentioning

confidence: 99%

Identifying Patterns of Self-Reported Nonadherence Using Network Analysis in a Mixed German Cohort

Prell¹,

Franke²,

Jagla-Franke³

et al. 2022

PPA

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Purpose Nonadherence is a complex behaviour that contributes to poor health outcomes; therefore, it is necessary to understand its underlying structure. Network analysis is a novel approach to explore the relationship between multiple variables. Patients and Methods Patients from four different studies (N = 1.746) using the self-reported Stendal Adherence to Medication Score (SAMS) were pooled. Network analysis using EBICglasso followed by confirmatory factor analysis were performed to understand how different types of nonadherence covered in the SAMS items are related to each other. Results Network analysis revealed different categories of nonadherence: lack of knowledge about medication, forgetting to take medication, and intentional modification of medication. The intentional modification can further be sub-categorized into two groups, with one group modifying medication based on changes in health (improvement of health or adverse effects), whereas the second group adjusts medication based on overall medication beliefs and concerns. Adverse effects and taking too many medications were further identified as most influential variables in the network. Conclusion The differentiation between modification due to health changes and modification due to overall medication beliefs is crucial for intervention studies. Network analysis is a promising tool for further exploratory studies of adherence.

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Medication Adherence and Coping with Disease in Patients from a Neurological Clinic: An Observational Study

Cited by 9 publications

References 54 publications

Using a generic quality of life measure to determine adherence thresholds: a cross-sectional study on older adults with neurological disorders in Germany

Using a generic quality of life measure to determine adherence thresholds: a cross-sectional study on older adults with neurological disorders in Germany

Muster von problematischem Kaufverhalten unter Studierenden und deren Unterschiede in Persönlichkeitsmerkmalen, materieller Werteorientierung, psychischer Belastung und Produktpräferenz

Identifying Patterns of Self-Reported Nonadherence Using Network Analysis in a Mixed German Cohort

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