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Assessing adherence to multiple medications and in daily life among patients with multimorbidity


Inauen, Jennifer; Bierbauer, Walter; Lüscher, Janina; König, Claudia; Tobias, Robert; Ihle, Andreas; Zimmerli, Lukas; Holzer, Barbara M; Battegay, Edouard; Siebenhüner, Klarissa; Kliegel, Matthias; Scholz, Urte (2017). Assessing adherence to multiple medications and in daily life among patients with multimorbidity. Psychology & Health:Epub ahead of print.

Abstract

OBJECTIVE: Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity). DESIGN: Eighty-four patients with multimorbidity and multiple-medication regimens completed three monthly panel questionnaires. A randomly assigned subsample additionally completed a 30-day daily diary. MAIN OUTCOME MEASURE: The Non-Adherence Report; a brief self-report measure of adherence to each prescribed medication (NAR-M), and in daily life. We further assessed the Medication Adherence Report Scale (MARS), and a subsample of participants were randomised to electronic adherence monitoring. RESULTS: The NAR-M indicated M = 94.7% adherence at Time 1 (SD = 9.3%). The NAR-M was significantly correlated with the MARS (rt1 = .52, rt2 = .57, and rt3 = .65; p < .001), and in tendency with electronically assessed adherence (rt2 = .45, rt3 = .46, p < .10). Variance components analysis indicated that between-person differences accounted for 10.2% of the variance in NAR-M adherence rates, whereas 22.9% were attributable to medication by person interactions. CONCLUSION: This study highlights the importance and feasibility of studying adherence to multiple medications differentially, and in daily life. Future studies may use these measures to investigate within-person and between-medication differences in adherence.

Abstract

OBJECTIVE: Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity). DESIGN: Eighty-four patients with multimorbidity and multiple-medication regimens completed three monthly panel questionnaires. A randomly assigned subsample additionally completed a 30-day daily diary. MAIN OUTCOME MEASURE: The Non-Adherence Report; a brief self-report measure of adherence to each prescribed medication (NAR-M), and in daily life. We further assessed the Medication Adherence Report Scale (MARS), and a subsample of participants were randomised to electronic adherence monitoring. RESULTS: The NAR-M indicated M = 94.7% adherence at Time 1 (SD = 9.3%). The NAR-M was significantly correlated with the MARS (rt1 = .52, rt2 = .57, and rt3 = .65; p < .001), and in tendency with electronically assessed adherence (rt2 = .45, rt3 = .46, p < .10). Variance components analysis indicated that between-person differences accounted for 10.2% of the variance in NAR-M adherence rates, whereas 22.9% were attributable to medication by person interactions. CONCLUSION: This study highlights the importance and feasibility of studying adherence to multiple medications differentially, and in daily life. Future studies may use these measures to investigate within-person and between-medication differences in adherence.

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Contributors:Department of Psychology , Columbia University , New York , NY , USA, Department of Psychology , University of Geneva , Geneva , Switzerland, Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva , Geneva , Switzerland, Swiss National Center of Competences in Research LIVES-Overcoming Vulnerability: Life Course Perspectives , Lausanne , Switzerland, Cantonal Hospital Olten , Olten , Switzerland
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
04 Faculty of Medicine > University Hospital Zurich > Clinic for Psychiatry and Psychotherapy
06 Faculty of Arts > Institute of Psychology
04 Faculty of Medicine > Center of Competence Multimorbidity
08 University Research Priority Programs > Dynamics of Healthy Aging
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2017
Deposited On:09 Jan 2017 10:20
Last Modified:16 Jan 2017 09:35
Publisher:Taylor & Francis
ISSN:0887-0446
Publisher DOI:https://doi.org/10.1080/08870446.2016.1275632
PubMed ID:28043163

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