Penner L S, Armitage C J, Thornley T, Whelan P, Chuter A, Allen T, Elliott R A
Janssen-Cilag GmbH, Johnson & Johnson Platz 1, 41470 Neuss, Germany.
Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, 4th Floor, Jean McFarlane Building, Manchester, M13 9PL UK.
Z Gesundh Wiss. 2023 Jan 19:1-14. doi: 10.1007/s10389-022-01813-0.
Medicines non-adherence is associated with poorer outcomes and higher costs. COVID-19 affected access to healthcare, with increased reliance on remote methods, including medicines supply. This study aimed to identify what affected people's adherence to medicines for long-term conditions (LTCs) during the pandemic.
Cross-sectional online survey of UK adults prescribed medicines for LTCs assessing self-reported medicines adherence, reasons for non-adherence (using the capability, opportunity and motivation model of behaviour [COM-B]), medicines access and COVID-19-related behaviours.
The 1746 respondents reported a mean (SD) of 2.5 (1.9) LTCs, for which they were taking 2.4 (1.9) prescribed medicines, 525 (30.1%) reported using digital tools to support ordering or taking medicines and 22.6% reported medicines non-adherence. No access to at least one medicine was reported by 182 (10.4%) respondents; 1048 (60.0%) reported taking at least one non-prescription medicine as a substitute; 409 (23.4%) requested emergency supply from pharmacy for at least one medicine. Problems accessing medicines, being younger, male, in the highest socioeconomic group and working were linked to poorer adherence. Access problems were mostly directly or indirectly related to the COVID-19 pandemic. Respondents were generally lacking in capabilities and opportunities, but disruptions to habits (automatic motivation) was the major reason for non-adherence.
Navigating changes in how medicines were accessed, and disruption of habits during the COVID-19 pandemic, was associated with suboptimal adherence. People were resourceful in overcoming barriers to access. Solutions to support medicines-taking need to take account of the multiple ways that medicines are prescribed and supplied remotely.
The online version contains supplementary material available at 10.1007/s10389-022-01813-0.
药物治疗依从性差与较差的治疗结果及更高的成本相关。新冠疫情影响了医疗服务的可及性,人们对包括药品供应在内的远程医疗方法的依赖增加。本研究旨在确定在疫情期间,哪些因素影响了患有长期疾病(LTC)的人群对药物的依从性。
对英国患有长期疾病并正在服用处方药的成年人进行横断面在线调查,评估自我报告的药物依从性、不依从的原因(使用行为的能力、机会和动机模型[COM-B])、药品获取情况以及与新冠疫情相关的行为。
1746名受访者报告平均患有2.5(1.9)种长期疾病,为此他们正在服用2.4(1.9)种处方药,525人(30.1%)报告使用数字工具来辅助订购或服药,22.6%的人报告存在药物治疗不依从情况。182名(10.4%)受访者表示至少有一种药物无法获取;1048人(60.0%)报告服用至少一种非处方药作为替代;409人(23.4%)向药房申请了至少一种药物的紧急供应。药品获取困难、年龄较小、男性、处于社会经济最高阶层以及工作与较差的依从性相关。获取问题大多直接或间接与新冠疫情有关。受访者普遍缺乏能力和机会,但习惯的改变(自动动机)是不依从的主要原因。
在新冠疫情期间,应对药品获取方式的变化以及习惯的改变与不理想的依从性相关。人们在克服获取障碍方面很有办法。支持服药的解决方案需要考虑到远程开处方和供应药品的多种方式。
在线版本包含可在10.1007/s10389-022-0,1813-0获取的补充材料。