Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Apr 25:8:519-63.
doi: 10.2147/PPA.S47290. eCollection 2014.

Psychosocial predictors of non-adherence to chronic medication: systematic review of longitudinal studies

Hanneke E Zwikker  1 , Bart J van den Bemt  2 , Johanna E Vriezekolk  1 , Cornelia H van den Ende  1 , Sandra van Dulmen  3
Affiliations
Review

Psychosocial predictors of non-adherence to chronic medication: systematic review of longitudinal studies

Hanneke E Zwikker et al. Patient Prefer Adherence. .

Abstract

Objectives: Several cross-sectional studies suggest that psychosocial factors are associated with non-adherence to chronic preventive maintenance medication (CPMM); however, results from longitudinal associations have not yet been systematically summarized. Therefore, the objective of this study was to systematically synthesize evidence of longitudinal associations between psychosocial predictors and CPMM non-adherence.

Materials and methods: PUBMED, EMBASE, CINAHL, and PsychINFO databases were searched for studies meeting our inclusion criteria. The reference lists and the ISI Web of Knowledge of the included studies were checked. Studies were included if they had an English abstract, involved adult populations using CPMM living in Western countries, and if they investigated associations between psychosocial predictors and medication non-adherence using longitudinal designs. Data were extracted according to a literature-based extraction form. Study quality was independently judged by two researchers using a framework comprising six bias domains. Studies were considered to be of high quality if ≥four domains were free of bias. Psychosocial predictors for non-adherence were categorized into five pre-defined categories: beliefs/cognitions; coping styles; social influences and social support; personality traits; and psychosocial well-being. A qualitative best evidence synthesis was performed to synthesize evidence of longitudinal associations between psychosocial predictors and CPMM non-adherence.

Results: Of 4,732 initially-identified studies, 30 (low-quality) studies were included in the systematic review. The qualitative best evidence synthesis demonstrated limited evidence for absence of a longitudinal association between CPMM non-adherence and the psychosocial categories. The strength of evidence for the review's findings is limited by the low quality of included studies.

Conclusion: The results do not provide psychosocial targets for the development of new interventions in clinical practice. This review clearly demonstrates the need for high-quality, longitudinal research to identify psychosocial predictors of medication non-adherence.

Keywords: longitudinal studies; medication adherence; psychosocial factors; somatic and chronic diseases; systematic review.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Psychosocial categories.
Figure 2
Figure 2
Flowchart of study inclusion process. Abbreviation: CPMM, chronic preventive maintenance medication.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ponieman D, Wisnivesky JP, Leventhal H, Musumeci-Szabó TJ, Halm EA. Impact of positive and negative beliefs about inhaled corticosteroids on adherence in inner-city asthmatic patients. Ann Allergy Asthma Immunol. 2009;103(1):38–42. - PubMed
    1. Venturini F, Nichol MB, Sung JC, Bailey KL, Cody M, McCombs JS. Compliance with sulfonylureas in a health maintenance organization: a pharmacy record-based study. Ann Pharmacother. 1999;33(3):281–288. - PubMed
    1. Gazmararian JA, Kripalani S, Miller MJ, Echt KV, Ren J, Rask K. Factors associated with medication refill adherence in cardiovascular-related diseases: a focus on health literacy. J Gen Intern Med. 2006;21(12):1215–1221. - PMC - PubMed
    1. Nabi H, Vahtera J, Singh-Manoux A, et al. Do psychological attributes matter for adherence to antihypertensive medication? The Finnish Public Sector Cohort Study. J Hypertens. 2008;26(11):2236–2243. - PMC - PubMed
    1. Grégoire J, Moisan J, Guibert R, Ciampi A, Milot A. Predictors of self-reported noncompliance with antihypertensive drug treatment: a prospective cohort study. Can J Cardiol. 2006;22(4):323–329. - PMC - PubMed

LinkOut - more resources