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Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis
AIM: To investigate the impact of medication beliefs, illness perceptions and quality of life on medication adherence in people with decompensated cirrhosis. METHODS: One hundred adults with decompensated cirrhosis completed a structured questionnaire when they attended for routine outpatient hepato...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677197/ https://www.ncbi.nlm.nih.gov/pubmed/29142479 http://dx.doi.org/10.3748/wjg.v23.i40.7321 |
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author | Hayward, Kelly L Valery, Patricia C Martin, Jennifer H Karmakar, Antara Patel, Preya J Horsfall, Leigh U Tallis, Caroline J Stuart, Katherine A Wright, Penny L Smith, David D Irvine, Katharine M Powell, Elizabeth E Cottrell, W Neil |
author_facet | Hayward, Kelly L Valery, Patricia C Martin, Jennifer H Karmakar, Antara Patel, Preya J Horsfall, Leigh U Tallis, Caroline J Stuart, Katherine A Wright, Penny L Smith, David D Irvine, Katharine M Powell, Elizabeth E Cottrell, W Neil |
author_sort | Hayward, Kelly L |
collection | PubMed |
description | AIM: To investigate the impact of medication beliefs, illness perceptions and quality of life on medication adherence in people with decompensated cirrhosis. METHODS: One hundred adults with decompensated cirrhosis completed a structured questionnaire when they attended for routine outpatient hepatology review. Measures of self-reported medication adherence (Morisky Medication Adherence Scale), beliefs surrounding medications (Beliefs about Medicines Questionnaire), perceptions of illness and medicines (Brief Illness Perception Questionnaire), and quality of life (Chronic Liver Disease Questionnaire) were examined. Clinical data were obtained via patient history and review of medical records. Least absolute shrinkage and selection operator and stepwise backwards regression techniques were used to construct the multivariable logistic regression model. Statistical significance was set at alpha = 0.05. RESULTS: Medication adherence was “High” in 42% of participants, “Medium” in 37%, and “Low” in 21%. Compared to patients with “High” adherence, those with “Medium” or “Low” adherence were more likely to report difficulty affording their medications (P < 0.001), lower perception of treatment helpfulness (P = 0.003) and stronger medication concerns relative to medication necessity beliefs (P = 0.003). People with “Low” adherence also experienced greater symptom burden and poorer quality of life, including more frequent abdominal pain (P = 0.023), shortness of breath (P = 0.030), and emotional disturbances (P = 0.050). Multivariable analysis identified having stronger medication concerns relative to necessity beliefs (Necessity-Concerns Differential ≤ 5, OR = 3.66, 95%CI: 1.18-11.40) and more frequent shortness of breath (shortness of breath score ≤ 3, OR = 3.87, 95%CI: 1.22-12.25) as independent predictors of “Low”adherence. CONCLUSION: The association between “Low” adherence and patients having strong concerns or doubting the necessity or helpfulness of their medications should be explored further given the clinical relevance. |
format | Online Article Text |
id | pubmed-5677197 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-56771972017-11-15 Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis Hayward, Kelly L Valery, Patricia C Martin, Jennifer H Karmakar, Antara Patel, Preya J Horsfall, Leigh U Tallis, Caroline J Stuart, Katherine A Wright, Penny L Smith, David D Irvine, Katharine M Powell, Elizabeth E Cottrell, W Neil World J Gastroenterol Observational Study AIM: To investigate the impact of medication beliefs, illness perceptions and quality of life on medication adherence in people with decompensated cirrhosis. METHODS: One hundred adults with decompensated cirrhosis completed a structured questionnaire when they attended for routine outpatient hepatology review. Measures of self-reported medication adherence (Morisky Medication Adherence Scale), beliefs surrounding medications (Beliefs about Medicines Questionnaire), perceptions of illness and medicines (Brief Illness Perception Questionnaire), and quality of life (Chronic Liver Disease Questionnaire) were examined. Clinical data were obtained via patient history and review of medical records. Least absolute shrinkage and selection operator and stepwise backwards regression techniques were used to construct the multivariable logistic regression model. Statistical significance was set at alpha = 0.05. RESULTS: Medication adherence was “High” in 42% of participants, “Medium” in 37%, and “Low” in 21%. Compared to patients with “High” adherence, those with “Medium” or “Low” adherence were more likely to report difficulty affording their medications (P < 0.001), lower perception of treatment helpfulness (P = 0.003) and stronger medication concerns relative to medication necessity beliefs (P = 0.003). People with “Low” adherence also experienced greater symptom burden and poorer quality of life, including more frequent abdominal pain (P = 0.023), shortness of breath (P = 0.030), and emotional disturbances (P = 0.050). Multivariable analysis identified having stronger medication concerns relative to necessity beliefs (Necessity-Concerns Differential ≤ 5, OR = 3.66, 95%CI: 1.18-11.40) and more frequent shortness of breath (shortness of breath score ≤ 3, OR = 3.87, 95%CI: 1.22-12.25) as independent predictors of “Low”adherence. CONCLUSION: The association between “Low” adherence and patients having strong concerns or doubting the necessity or helpfulness of their medications should be explored further given the clinical relevance. Baishideng Publishing Group Inc 2017-10-28 2017-10-28 /pmc/articles/PMC5677197/ /pubmed/29142479 http://dx.doi.org/10.3748/wjg.v23.i40.7321 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Observational Study Hayward, Kelly L Valery, Patricia C Martin, Jennifer H Karmakar, Antara Patel, Preya J Horsfall, Leigh U Tallis, Caroline J Stuart, Katherine A Wright, Penny L Smith, David D Irvine, Katharine M Powell, Elizabeth E Cottrell, W Neil Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis |
title | Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis |
title_full | Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis |
title_fullStr | Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis |
title_full_unstemmed | Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis |
title_short | Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis |
title_sort | medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis |
topic | Observational Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677197/ https://www.ncbi.nlm.nih.gov/pubmed/29142479 http://dx.doi.org/10.3748/wjg.v23.i40.7321 |
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