Intentional Non-adherence (intentional + non-adherence)

Distribution by Scientific Domains


Selected Abstracts


Beliefs of chronically ill Japanese patients that lead to intentional non-adherence to medication

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 5 2004
N. Iihara BS
Summary Objective:, To identify factors, associated with personal beliefs, involved in intentional non-adherence to prescribed medication of Japanese patients with chronic diseases. Methods:, A cross-sectional study of Japanese subjects with chronic, primarily liver, gastrointestinal, or nervous system diseases who had been prescribed oral medicines for regular use, was performed. The subjects were admitted to a university hospital and were interviewed face-to-face on admission. Intentional non-adherence was defined as experience of deliberate adjustment of self-managed prescription medicines during the few months prior to hospital admission. Patients' beliefs about taking medicines were assessed from the perspective of what the patient valued in order to take medicines without anxiety; whether the patient valued information about the medication such as its function and side-effects and/or mutual reliance on doctors. Using logistic multivariate regression analyses, factors associated with intentional non-adherence were identified. Results:, Among 154 subjects, 51 showed intentional non-adherence. Intentional non-adherence was associated with the following three factors: (a) the patients' beliefs with respect to taking medicines without anxiety, especially putting no value on mutual reliance on the patient,doctor relationship (P < 0·001) and putting great value on knowing the drug's side-effects (P < 0·001), (b) poor comprehension of general aspects of medication (P for trend <0·001), and (c) being in the prime of life (40,59 years) (P = 0·011). Comprehension of the function of each medicine, experience of side-effects, anxiety about taking medicines, and the number of types of medicines taken, were not associated with non-adherence. Conclusions:, Beliefs on which individual Japanese patients with chronic diseases attach value in order to take medicines without anxiety were potential factors for intentional non-adherence. This emphasizes the necessity of a patient-oriented approach to take account of patients' personal beliefs about medicines to increase adherence rate in Japan. [source]


An examination of the intentional and unintentional aspects of medication non-adherence in patients diagnosed with hypertension

JOURNAL OF CLINICAL NURSING, Issue 4 2007
Elaine Lehane MSc
Aims., The primary aim of this study was to describe the unintentional and intentional aspects of non-adherence in patients diagnosed with hypertension. A secondary aim was to examine the relationships between medication adherence and purposeful actions (intentional non-adherence), patterned behaviours (unintentional non-adherence) and demographic questionnaire variables. Background., Non-adherence to medications continues to be a significant health-care issue, the extent and consequences of which have been well documented. Despite considerable research over the past five decades, little progress has been made in solving this healthcare problem. Recent literature indicates that this lack of progress can be attributed to the fact that past research has concentrated solely upon either the unintentional or the intentional aspects of non-adherence, instead of addressing both facets simultaneously. Methods., A quantitative, descriptive, correlation research design was employed using Johnson's (2002) Medication Adherence Model as a theoretical framework. A convenience sample of 73 participants with hypertension, attending the outpatients' clinics of two university hospitals was recruited. Data were collected by means of a researcher administered questionnaire and analysed using the Statistical Package for Social Sciences. Results., High levels of medication adherence with a mean adherence score of 4·75 (maximum 5) were reported. Low and medium levels of purposeful actions and medium and high levels of patterned behaviours towards medication taking were found. Correlational analyses did not demonstrate statistically significant associations. Conclusions., Both the intentional and unintentional dimensions of medication-taking are simultaneously considered by patients to varying levels when adhering to therapeutic regimens. This is an important research area for nurses as it facilitates an increased understanding of non-adherence and, in so doing, aids the uncovering of more effective interventions aimed at sustaining lifelong pharmacotherapy. Relevance to clinical practice., By acknowledging a broader approach to patient medication-taking, nurses will be able more effectively to assess and intervene in non-adherent behaviours and actions. [source]


Beliefs of chronically ill Japanese patients that lead to intentional non-adherence to medication

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 5 2004
N. Iihara BS
Summary Objective:, To identify factors, associated with personal beliefs, involved in intentional non-adherence to prescribed medication of Japanese patients with chronic diseases. Methods:, A cross-sectional study of Japanese subjects with chronic, primarily liver, gastrointestinal, or nervous system diseases who had been prescribed oral medicines for regular use, was performed. The subjects were admitted to a university hospital and were interviewed face-to-face on admission. Intentional non-adherence was defined as experience of deliberate adjustment of self-managed prescription medicines during the few months prior to hospital admission. Patients' beliefs about taking medicines were assessed from the perspective of what the patient valued in order to take medicines without anxiety; whether the patient valued information about the medication such as its function and side-effects and/or mutual reliance on doctors. Using logistic multivariate regression analyses, factors associated with intentional non-adherence were identified. Results:, Among 154 subjects, 51 showed intentional non-adherence. Intentional non-adherence was associated with the following three factors: (a) the patients' beliefs with respect to taking medicines without anxiety, especially putting no value on mutual reliance on the patient,doctor relationship (P < 0·001) and putting great value on knowing the drug's side-effects (P < 0·001), (b) poor comprehension of general aspects of medication (P for trend <0·001), and (c) being in the prime of life (40,59 years) (P = 0·011). Comprehension of the function of each medicine, experience of side-effects, anxiety about taking medicines, and the number of types of medicines taken, were not associated with non-adherence. Conclusions:, Beliefs on which individual Japanese patients with chronic diseases attach value in order to take medicines without anxiety were potential factors for intentional non-adherence. This emphasizes the necessity of a patient-oriented approach to take account of patients' personal beliefs about medicines to increase adherence rate in Japan. [source]


Adherence in adolescents and young adults following heart or heart-lung transplantation

PEDIATRIC TRANSPLANTATION, Issue 6 2006
Jo Wray
Abstract:, To assess the prevalence and some potential correlates of non-adherence to medications in adolescent and young adult transplant patients. Fifty patients who had undergone heart or heart-lung transplantation 1.4,14.9 yr (mean 8.8 yr) previously completed the Beliefs about Medication Questionnaire (BMQ), Perceived Illness Experience (PIE) scale and a demographics questionnaire. Medical notes were reviewed for information regarding previous psychiatric referral, rejection episodes and complications and noted concerns about adherence. Forty (80%) completed questionnaires were received. Non-adherence determined from the questionnaires was associated with forgetting to take medication and was classified as unintentional non-adherence. Such non-adherence was reported by 11 (28%) patients. Seven patients (18%) showed evidence from their records of deliberate non-adherence, which was classified as intentional. Whilst intentional non-adherence was associated with depression and transplant-related lymphoma, unintentional non-adherence and perceived difficulties with medications were associated with high scores on the PIE preoccupation with illness and BMQ concerns subscale and with drinking alcohol. Future research is required to determine whether unintentional non-adherence results in significant medical complications in the longer term and how a reduction in the prevalence of non-adherence can be facilitated. [source]