Why do patients not adhere to prescribed medication regimes? Results of two German surveys (Artikel)

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Why do patients not adhere to prescribed medication regimes? Results of two German surveys (Artikel)
Autor Thomas Wilke, Sabrina Müller
In: Value in Health
Ausgabe 13 (7)
ISBN/ISSN:
Erscheinungsjahr 2010
Jahrgang November 2010
Seitenzahl A380
Hyperlink
Review

OBJECTIVES: The aim of this study is to answer the following questions: 1) How high is the self-reported nonadherence (NA) of German patients with the need to regularly take medication? and 2) Which factors capable of explaining this self-reported NA can be identifi ed by multivariate analysis? METHODS: Two cross-sectional surveys (phone survey with 1177 patients; face-to-face in-depth survey with 340 patients in 17 German pharmacies) were conducted. Self-reported NA was measured by the generic Morisky scale (either as 4 items or 8 item MMAS). Identifi cation of explanatory factors was conducted on the basis of multivariate logistic regression analysis (including the calculation of additive risks by dichotomization of signifi cant explanatory factors). RESULTS: 1) Approximately 35–40 % of the patients can be described as non-adherent (38.8 %/35.3 %); 2a) Survey 1: Only a few socio-demographic factors are able to explain the NA (chronic disease, some aspects of age, and low number of required medications to take); and 2b) Survey 2: Most results of the fi rst survey can be replicated. However, intentional NA explanations have considerably more infl uence: positive medication belief, a positive mood, and a good patientdoctor relationship reduce the NA risk. Furthermore, patients who are easily able to recognize the correct medication on the basis of the identifi cation of the packaging have a signifi cantly reduced NA probability. When additive risk is considered, patients who are chronically ill but display no other risk factors have an NA probability rate of 10.4 %, for patients displaying all identifi ed risk factors this rate increases to 93.9 %. CONCLUSIONS: Our surveys are the largest and most detailed to have been conducted in Germany concerned with the theme of medication-based NA. Our results show that approximately one-third of patients can be classifi ed as non-adherent. Intentional NA factors explain the NA considerably better than do socio-economic factors.