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. 2020 Dec 14:14:2439-2450.
doi: 10.2147/PPA.S281985. eCollection 2020.

Different Associations of Intentional and Non-Intentional Non-Adherence Behaviors with Patient Experience with Healthcare and Patient Beliefs in Medications: A Survey of Patients with Chronic Conditions

Luis Cea-Calvo  1 , Ignacio Marín-Jiménez  2 , Javier de Toro  3 , María J Fuster-RuizdeApodaca  4   5 , Gonzalo Fernández  1 , Nuria Sánchez-Vega  1 , Domingo Orozco-Beltrán  6
Affiliations

Different Associations of Intentional and Non-Intentional Non-Adherence Behaviors with Patient Experience with Healthcare and Patient Beliefs in Medications: A Survey of Patients with Chronic Conditions

Luis Cea-Calvo et al. Patient Prefer Adherence. .

Abstract

Purpose: To investigate relationships between intentional and non-intentional non-adherence behaviors and patient experience with healthcare and beliefs in medications.

Patients and methods: This is a post hoc analysis of a cross-sectional anonymous survey distributed between May and September 2017 to patients with rheumatic disease, inflammatory bowel disease, HIV infection or diabetes mellitus from outpatient and primary care clinics in Spain. Patients answered five questions about non-adherence behaviors and completed questionnaires on their experience with healthcare (IEXPAC: Instrument to Evaluate the EXperience of PAtients with Chronic diseases) and beliefs about medicines (BMQ: Beliefs About Medicines Questionnaire).

Results: Among 1530 respondents, 53% showed ≥1 non-adherence behavior; 35% had ≥1 non-intentional non-adherence behavior, and 33% had ≥1 intentional non-adherence behavior. Patients with HIV infection had the lowest frequency of intentional non-adherence behaviors. Non-intentional non-adherence was associated with patient beliefs (inversely with BMQ overall score) and patient experiences (inversely with IEXPAC Factor 3 sub-score, self-management). Intentional non-adherence was strongly associated with beliefs scores (directly with BMQ concerns and inversely with BMQ necessity sub-score) and inversely associated with HIV infection.

Conclusion: The different associations of intentional and non-intentional non-adherence behaviors found in this study help to understand how patient experiences and beliefs influence medical non-adherence, and in the development of strategies for reducing non-adherence.

Keywords: BMQ; IEXPAC; chronic disease; intentional behavior; medication adherence; patient beliefs.

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Conflict of interest statement

Luis Cea-Calvo: full-time employee at MSD Spain. Ignacio Marín-Jiménez: board membership or consultancy for AbbVie, Chiesi, FAES Farma, Falk-Pharma, Ferring, Gebro Pharma, Hospira, Janssen, MSD, Otsuka Pharmaceutical, Pfizer, Shire, Takeda, Tillotts, and UCB Pharma, payments for lectures from AbbVie, Chiesi, FAES Farma, Falk- Pharma, Ferring, Gebro Pharma, Hospira, Janssen, MSD, Otsuka Pharmaceutical, Pfizer, Shire, Takeda, Tillotts and UCB Pharma. Javier de Toro: no conflict of interest. María J. Fuster-RuizdeApodaca: grants (to her institution) from MSD, Spain, Janssen Cilag, Gilead Sciences and ViiV Healthcare; consultancy for Gilead Sciences, MSD, Janssen and ViiV Healthcare; payments for lectures (to her institution) from MSD, Spain, Gilead Sciences and ViiV Healthcare. Gonzalo Fernández: full-time employee at MSD Spain. Nuria Sánchez-Vega: full-time employee at MSD Spain. Domingo Orozco-Beltrán: consultancy and lectures for MSD, Sanofi, Novo Nordisk, Mundipharma, Menarini. Employees from the Medical Affairs department of the funding company (MSD Spain) had an active role in the design, data acquisition, analysis and interpretation. Writing and publishing the current analysis was a decision of all the authors. Data analysis was performed by a third party (Bio-estadística consultora), under the guidance of the authors. The authors report no other potential conflicts of interest for this work.

Figures

Figure 1
Figure 1
Frequency of non-adherence behaviors (non-intentional, intentional or mixed) in the different patient cohorts. Data are shown as percentages.
Figure 2
Figure 2
Frequency of non-adherence behaviors (non-intentional, intentional or mixed) by (A) quartiles of experience score (IEXPAC) and (B) quartiles of overall Beliefs in Medicines (BMQ) score. Data are shown as percentages. Quartiles of IEXPAC overall score: Q1: <4.77; Q2: 4.77–6.36; Q3: 6.36–7.27; Q4: >7.27. Quartiles of BMQ overall score: Q1: <2; Q2: 2–6; Q3: 6–11; Q4: >11.
See this image and copyright information in PMC

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