Potential risk factors for medication non-adherence in patients with chronic obstructive pulmonary disease (COPD)
Potential risk factors for medication non-adherence in patients with chronic obstructive pulmonary disease (COPD)
Date
2012-04-05
Authors
Khdour, Maher R.
Hawwa, Ahmed F.
Kidney, Joseph C.
Smyth, Bronagh M.
McElnay, James C.
Journal Title
Journal ISSN
Volume Title
Publisher
Springer-Verlag 2012
Abstract
Aims To investigate the effect of a range of demographic
and psychosocial variables on medication adherence in
chronic obstructive pulmonary disease (COPD) patients
managed in a secondary care setting.
Methods A total of 173 patients with a confirmed diagnosis
of COPD, recruited from an outpatient clinic in Northern
Ireland, participated in the study. Data collection was carried
out via face-to-face interviews and through review of
patients’ medical charts. Social and demographic variables,
co-morbidity, self-reported drug adherence (Morisky scale),
Hospital Anxiety and Depression (HAD) scale, COPD
knowledge, Health Belief Model (HBM) and self-efficacy
scales were determined for each patient.
Results Participants were aged 67±9.7 (mean ± SD) years,
56 % female and took a mean (SD) of 8.2±3.4 drugs. Low
adherence with medications was present in 29.5 % of the
patients. Demographic variables (gender, age, marital status,
living arrangements and occupation) were not associated with
adherence. A range of clinical and psychosocial variables, on
the other hand, were found to be associated with medication
adherence, i.e. beliefs regarding medication effectiveness,
severity of COPD, smoking status, presence of co-morbid
illness, depressed mood, self-efficacy, perceived susceptibility
and perceived barriers within the HBM (p<0.05). Logistic
regression analysis showed that perceived ineffectiveness of
medication, presence of co-morbid illness, depressed mood
and perceived barriers were independently associated with
medication non-adherence in the study (P<0.05).
Conclusions Adherence in COPD patients is influenced
more by patients’ perception of their health and medication
effectiveness, the presence of depressed mood and comorbid
illness than by demographic factors or disease
severity.
Description
Keywords
Adherence, COPD, Health beliefs, Depression, Self-efficacy, Disease knowledge