The Incidence and Determinants of Primary Nonadherence With Prescribed Medication in Primary Care

Tamblyn, Robyn; Eguale, Tewodros; Huang, Allen; Winslade, Nancy; Doran, Pamela

doi:10.7326/m13-1705

Cited by 175 publications

(176 citation statements)

References 60 publications

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“…Our findings support recommendations that prescribers consider whether patients can afford their medications. 22 Our findings also suggest that prescribers might consider asking whether patients are making related trade-offs. Furthermore, prescribers should be aware of the higher potential for costrelated nonadherence, and related trade-offs, in female patients, Aboriginal persons and those with poorer health status.…”

Section: Discussionmentioning

confidence: 93%

The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey

et al. 2018

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Section: Discussionmentioning

confidence: 93%

The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey

et al. 2018

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“…6, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32 Reflecting this perspective, a multilevel approach to medication nonadherence is novel,15, 33 as multilevel medication nonadherence factors have received little attention in transplantation 6, 11, 13, 14, 34. Should this new perspective reveal independent multilevel immunosuppressant nonadherence correlates, addressing such correlates would demand interventional approaches targeting not only patients but healthcare workers/family, organizations, and policymakers 6, 21, 24…”

Section: Introductionmentioning

confidence: 99%

Multilevel factors are associated with immunosuppressant nonadherence in heart transplant recipients: The international BRIGHT study

Denhaerynck

Berben

Dobbels

et al. 2018

American Journal of Transplantation

100

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Factors at the level of family/healthcare worker, organization, and system are neglected in medication nonadherence research in heart transplantation (HTx). The 4‐continent, 11‐country cross‐sectional Building Research Initiative Group: Chronic Illness Management and Adherence in Transplantation (BRIGHT) study used multistaged sampling to examine 36 HTx centers, including 36 HTx directors, 100 clinicians, and 1397 patients. Nonadherence to immunosuppressants—defined as any deviation in taking or timing adherence and/or dose reduction—was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale© (BAASIS ©) interview. Guided by the Integrative Model of Behavioral Prediction and Bronfenbrenner's ecological model, we analyzed factors at these multiple levels using sequential logistic regression analysis (6 blocks). The nonadherence prevalence was 34.1%. Six multilevel factors were associated independently (either positively or negatively) with nonadherence: patient level: barriers to taking immunosuppressants (odds ratio [OR]: 11.48); smoking (OR: 2.19); family/healthcare provider level: frequency of having someone to help patients read health‐related materials (OR: 0.85); organization level: clinicians reporting nonadherent patients were targeted with adherence interventions (OR: 0.66); pickup of medications at physician's office (OR: 2.31); and policy level: monthly out‐of‐pocket costs for medication (OR: 1.16). Factors associated with nonadherence are evident at multiple levels. Improving medication nonadherence requires addressing not only the patient, but also family/healthcare provider, organization, and policy levels.

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“…Os estudos de não-adesão primária são limitados, caros e difíceis de executar, pela dificuldade de rastreamento das prescrições médicas, que na maioria das vezes são escritas à mão. A prescrição eletrônica com dados integrados à dispensação criou uma oportunidade para estimar a não-adesão primária 50,60 . Há várias definições relacionadas ao tempo estimado para o não aviamento da nova prescrição na não-adesão primária.…”

Section: Tipos De Não-adesãounclassified

Adesão À Farmacoterapia, Que Universo É Esse? Uma Revisão Narrativa

Oliboni

Castro

2018

Clin. Biomed. Res.

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RESUMOA não-adesão à farmacoterapia foi primeiramente identificada há mais de 2000 anos e continua a ser um desafio, gerando intenso debate nos dias de hoje. Percebe-se que houve um aumento nas pesquisas que procuram elucidar a extensão, as causas e as consequências da não-adesão à farmacoterapia. No entanto, para entender a extensão de adesão é necessário compreender o seu conceito. Para tanto, é necessário esclarecer a diferença dos diversos termos utilizados em pesquisas de adesão, tais como cumprimento, adesão, concordância e persistência. Com o objetivo de elucidar essas e muitas outras questões, conduziu-se um mapeamento da literatura existente sobre adesão à farmacoterapia. Esta revisão narrativa foi conduzida sem limitação temporal, por meio de buscas realizadas nas bases de dados MEDLINE/PubMed e Scielo. Utilizaram-se os descritos em Ciências da Saúde (DeCS) (Medication Adherence e Adesão à Medicação; Patient Compliance e Cooperação do Paciente; Terminology e Terminologia); os termos MESH (drug therapy, medication adherence, medication therapy management, patient compliance, terminology); e outros termos gerais. Apesar de existir uma vasta literatura sobre o conceito de adesão à medicação, não há um consenso padrão estabelecido. Os termos compliance, adherence e concordance têm sido utilizados erroneamente como termos intercambiáveis de adesão à medicação. Alguns autores categorizam a não-adesão em intencional e não intencional; outros em repetida ou esporádica ou, ainda, em primária ou secundária. A adesão é um comportamento multifatorial complexo que é influenciado por diversos fatores, que muitas vezes são controversos e inconsistentes nas publicações. Apesar de existir um universo rico e promissor no campo de adesão à farmacoterapia, há muita complexidade e contradição. Muito do que se reporta à adesão é de certa forma fragmentado e controverso, o que dificulta a análise deste processo como um todo. Palavras-chave: Revisão narrativa; adesão à medicação; terminologia ABSTRACTNon-adherence to medication was first noted over 2000 years ago and remains a challenge; the issue continues to generate intense debate. A surge in research in this area has helped to elucidate the extent, causes and consequences of patient non-adherence. However, how do we elucidate the extent of adherence without understanding its concept? What is the difference between the terms used in research in this field, such as compliance, adherence, concordance and persistence? A mapping of the existing literature on adherence to medication was conducted in order to answer this and other questions. This narrative review was conducted with no time limit, by searching MEDLINE/PubMed and Scielo databases. Health science descriptors (DeCS) were applied (Medication Adherence; Patient Compliance; Surveys and Questionnaires and Terminology); MESH terms (drug therapy, medication adherence, medication therapy management, patient compliance, terminology); and other terms. Although there is a vast literature on the concept of adherence to medicat...

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The Incidence and Determinants of Primary Nonadherence With Prescribed Medication in Primary Care

Abstract: Canadian Institutes of Health Research.

Cited by 175 publications

References 60 publications

The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey

The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey

Multilevel factors are associated with immunosuppressant nonadherence in heart transplant recipients: The international BRIGHT study

Adesão À Farmacoterapia, Que Universo É Esse? Uma Revisão Narrativa

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