Kim Sung Reul, Kim Ji Young, Kim Hye Young, So Hui Young, Chung Sun Ju
College of Nursing, Korea University Nursing Research Institute, Korea University, Seoul, Korea.
College of Nursing, Jeonbuk National University, Jeonju, Korea.
J Mov Disord. 2021 May;14(2):133-143. doi: 10.14802/jmd.20147. Epub 2021 May 3.
Medication beliefs are a significant determinant of medication adherence in chronic illness. This study aimed to identify demographic, clinical, and medication-related factors associated with medication beliefs in patients with Parkinson's disease (PD).
We used a descriptive cross-sectional design with a convenience sample of 173 PD patients who had been taking antiparkinson drugs for more than one year.
The subjects who believed PD medication was more necessary had more severe illness, younger age of onset, longer illness duration, and longer duration of levodopa therapy. They had higher levels of non-motor symptoms and depression, number of medication uses, number of drugs, and levodopa equivalent dose, and they reported fluctuation of motor symptoms and dyskinesia. The subjects who used catechol-O-methyltransferase (COMT) inhibitors, dopamine agonists, amantadine, and monoamine oxidase-B (MAO-B) inhibitors had significantly higher necessity scores than those who did not use them. The subjects who had higher concerns about PD medications had higher levels of non-motor symptoms and depression. The subjects using amantadine and anticholinergics had significantly higher concern scores than those who did not use them. Positive necessity-concerns differentials were associated with severe illness, the presence of motor fluctuation and dyskinesia, and the use of COMT inhibitors. Based on stepwise multiple regression, the most significant factors influencing necessity beliefs were severe illness, followed by depression and motor fluctuation.
Severe illness, higher levels of depression, and motor fluctuation are independent factors influencing patients' beliefs regarding medication necessity. Therefore, these characteristics should be considered in medication belief assessment and interventions for PD patients.
药物信念是慢性病患者药物依从性的一个重要决定因素。本研究旨在确定帕金森病(PD)患者中与药物信念相关的人口统计学、临床和药物相关因素。
我们采用描述性横断面设计,对173例服用抗帕金森药物超过一年的PD患者进行便利抽样。
认为PD药物更有必要的受试者病情更严重、发病年龄更小、病程更长、左旋多巴治疗时间更长。他们的非运动症状和抑郁水平更高,用药次数、药物种类和左旋多巴等效剂量更多,并且他们报告有运动症状波动和异动症。使用儿茶酚-O-甲基转移酶(COMT)抑制剂、多巴胺激动剂、金刚烷胺和单胺氧化酶-B(MAO-B)抑制剂的受试者的必要性得分显著高于未使用者。对PD药物关注度较高的受试者非运动症状和抑郁水平较高。使用金刚烷胺和抗胆碱能药物的受试者的关注度得分显著高于未使用者。积极的必要性-关注度差异与病情严重程度、运动波动和异动症的存在以及COMT抑制剂的使用有关。基于逐步多元回归分析,影响必要性信念的最显著因素是病情严重程度,其次是抑郁和运动波动。
病情严重程度、较高的抑郁水平和运动波动是影响患者药物必要性信念的独立因素。因此,在对PD患者进行药物信念评估和干预时应考虑这些特征。