German Centre of Gerontology, Berlin, Germany.
J Psychosom Res. 2011 Feb;70(2):179-87. doi: 10.1016/j.jpsychores.2010.07.014. Epub 2010 Sep 18.
To examine factors preventing medication nonadherence in community-dwelling older adults with multiple illnesses (multimorbidity). Nonadherence threatens successful treatment of multimorbidity. Adherence problems can be intentional (e.g., deliberately choosing not to take medicines or to change medication dosage) or unintentional (e.g., forgetting to take medication) and might depend on a range of factors. This study focused in particular on the role of changes in beliefs about medication to explain changes in adherence.
Longitudinal study with N = 309 individuals aged 65-85 years with two or more diseases at three measurement points over six months. Medication adherence and beliefs about medicines were assessed by questionnaire. Hierarchical weighted least squares regression analyses were used to predict individual intentional and unintentional nonadherence.
Changes in intentional nonadherence were predicted by changes in specific necessity beliefs (B = -.19, P<.01), after controlling for sociodemographic factors, health status and number of prescribed medicines. Changes in unintentional nonadherence were predicted by changes in general overuse beliefs (B = .26, P<.01), controlling for the same covariates.
Beliefs about medication affect both intentional and unintentional adherence to medication in multimorbid older adults. This points to the importance of addressing medication beliefs in patient education to improve adherence.
研究防止患有多种疾病(多病共存)的社区老年人药物不依从的因素。不依从会威胁多病共存的治疗效果。依从问题可能是有意的(例如,故意选择不服用药物或改变药物剂量),也可能是无意的(例如,忘记服用药物),并可能取决于一系列因素。本研究特别关注对药物信念的改变,以解释依从性的变化。
这是一项纵向研究,共有 309 名年龄在 65-85 岁、患有两种或两种以上疾病的个体,在六个月内进行了三次测量。通过问卷评估药物依从性和对药物的信念。使用分层加权最小二乘回归分析来预测个体的有意和无意不依从。
在控制社会人口统计学因素、健康状况和开处方药物数量后,特定必要性信念的变化(B=-.19,P<.01)预测了有意不依从的变化。一般过度使用信念的变化(B=.26,P<.01)预测了无意不依从的变化,控制了相同的协变量。
对药物的信念会影响多病共存的老年患者对药物的有意和无意依从性。这表明在患者教育中解决药物信念以提高依从性的重要性。