Patient Beliefs Have a Greater Impact Than Barriers on Medication Adherence in a Community Health Center

Gagnon, Monica; Waltermaurer, Eve; Martin, Adam; Friedenson, Colette; Gayle, Eric; Hauser, Diane

doi:10.3122/jabfm.2017.03.160129

Cited by 39 publications

(34 citation statements)

References 17 publications

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“…In contrast, psychological factors such as medication beliefs and patients' perceptions about disease and medications were, however, briefly investigated by only two studies. Yet, previous studies on chronic medication adherence have shown that these behaviour perceptions are better predictors of adherence than socio‐demographic factors . We therefore propose that psychological factors be included when assessing potential correlates of PMN given their potential significance.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and factors associated with primary medication non‐adherence in chronic disease: A systematic review and meta‐analysis

et al. 2019

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Background: Primary medication non-adherence (PMN), defined as failure to obtain newly prescribed medications, results in adverse clinical and economic outcomes.We aimed to (a) assess the prevalence of PMN in six common chronic diseases: asthma and/ or chronic obstructive pulmonary disease, depression, diabetes mellitus, hyperlipidaemia, hypertension and osteoporosis; (b) identify and categorise factors associated with PMN; (c) explore characteristics that contributed to heterogeneity between studies. Methods:We performed a systematic search in MEDLINE, Embase, Cochrane Library, CINAHL and PsycINFO. Studies published in English between January 2008 and August 2018 assessing PMN in subjects aged ≥18 years were included. We used the Cochrane risk of bias tool, Newcastle-Ottawa Scale and National Heart, Lung and Blood Institute Quality Assessment Tool to assess the quality of randomised controlled trials, cohort and cross-sectional studies, respectively. Findings were reported using the PRISMA checklist. PMN rates were pooled using a random effects model. We summarised factors associated with PMN descriptively. Subgroup analysis was performed to explore sources of heterogeneity. Results:We screened 3083 articles and included 33 (5 randomised controlled trials, 26 cohort and 2 cross-sectional studies, n = 539 156), of which 31 (n = 519 971) were used in meta-analysis. The pooled PMN rate was 17% (95% CI: 15%-20%). Pooled PMN rates were highest in osteoporosis (25%, 95% CI: 7%-44%) and hyperlipidaemia (25%, 95% CI: 18%-32%) and lowest in diabetes mellitus (10%, 95% CI: 7%-12%).Factors commonly associated with PMN include younger age, number of concurrent medications, practitioner specialty and higher co-payment. Type of chronic disease, age, study setting and PMN definition contributed to heterogeneity between studies (all P < 0.001). Conclusion:Primary medication non-adherence is common among patients with chronic diseases and more needs to be done to address this issue in order to improve patient outcomes. Future PMN studies could benefit from greater standardisation to enhance comparability.

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Section: Discussionmentioning

confidence: 99%

Prevalence of and factors associated with primary medication non‐adherence in chronic disease: A systematic review and meta‐analysis

et al. 2019

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“… 6 7 One of the biggest factors affecting concordance is the patient’s personal belief about the disease and medications. 8 Studies have shown that in order to improve adherence with DMARDs, clinicians should focus less on provision of medical information and be more aware of patients’ beliefs. 9 Understanding patient beliefs however is difficult and often relies on qualitative studies which are excellent at providing an in-depth thematic analysis of a specific issue, but are traditionally conducted on a small scale.…”

Section: Introductionmentioning

confidence: 99%

Mining social media data to investigate patient perceptions regarding DMARD pharmacotherapy for rheumatoid arthritis

et al. 2020

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ObjectivesWe hypothesise that patients have a positive sentiment regarding biological/targeted synthetic disease modifying anti-rheumatic drugs (b/tsDMARDs) and a negative sentiment towards conventional synthetic agents (csDMARDs). We analysed discussions on social media platforms regarding DMARDs to understand the collective sentiment expressed towards these medications.MethodsTreato analytics were used to download all available posts on social media about DMARDs in the context of rheumatoid arthritis. Strict filters ensured that user generated content was downloaded. The sentiment (positive or negative) expressed in these posts was analysed for each DMARD using sentiment analysis. We also analysed the reason(s) for this sentiment for each DMARD, looking specifically at efficacy and side effects.ResultsComputer algorithms analysed millions of social media posts and included 54 742 posts about DMARDs. We found that both classes had an overall positive sentiment. The ratio of positive to negative posts was higher for b/tsDMARDs (1.210) than for csDMARDs (1.048). Efficacy was the most commonly mentioned reason in posts with a positive sentiment and lack of efficacy was the most commonly mentioned reason for a negative sentiment. These were followed by the presence/absence of side effects in negative or positive posts, respectively.ConclusionsPublic opinion on social media is generally positive about DMARDs. Lack of efficacy followed by side effects were the most common themes in posts with a negative sentiment. There are clear reasons why a DMARD generates a positive or negative sentiment, as the sentiment analysis technology becomes more refined, targeted studies could be done to analyse these reasons and allow clinicians to tailor DMARDs to match patient needs.

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“…8 Thus, general questions such as, "What keeps you from taking the medicine?," "What would get you to take the medicine?," or "How do you feel about this medicine?" may assist in determining the real reasons people are not taking prescribed medications.…”

Section: Decision: Recognize the Real Reasons/beliefs Behind Patient mentioning

confidence: 99%

Research on Clinical Decisions Made Daily in Family Medicine

Bowman¹,

Neale²,

Seehusen³

2017

J Am Board Fam Med

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This issue presents research on the types of decisions that are required daily in family medicine. Patients often make these health decisions, and family physicians help patients with these decisions daily. Patients and their family physicians discuss when to quit screening for colon cancer, which treatment to choose for localized prostate cancer, when to test for pertussis when a cough is present, whether to take prescribed medications, how to complete more preventive services, and how to understand the "new genetics", and family physician use of telehealth. Decision: Intensity of Depression InterventionThe DOC-6 1 can help providers predict which patients with depression are likely to enter remission and which are likely to continue to suffer from persistent depressive symptoms after 6 months. This tool is based on demographic factors and familiar, commonly used instruments. The factors in the final instrument are intuitive and consistent with well-known literature, and most family physicians would be able to predict them. Advantages are that the instrument can be scored by office staff and is thus more straightforward than physician "intuition." Notably, this study was done in the setting of an established, reliable collaborative care model for patients with depression.

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Patient Beliefs Have a Greater Impact Than Barriers on Medication Adherence in a Community Health Center

Cited by 39 publications

References 17 publications

Prevalence of and factors associated with primary medication non‐adherence in chronic disease: A systematic review and meta‐analysis

Prevalence of and factors associated with primary medication non‐adherence in chronic disease: A systematic review and meta‐analysis

Mining social media data to investigate patient perceptions regarding DMARD pharmacotherapy for rheumatoid arthritis

Research on Clinical Decisions Made Daily in Family Medicine

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