Impacts on practice
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Multiple long-term medicines use affects different aspects of patients’ daily lives, and this impact needs to be recognized.
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Health care providers should consider this medication-related burden on patients when managing chronic conditions.
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Health care providers should make an effort to support patients to better integrate long-term medicine use in their daily and social lives.
Introduction
Aim of the study
Ethics approval
Method
Study design
Study population
Selection procedure
Non-adherent sample
Adherent sample
Data collection
Data analysis
Results
Selected patients
Patient characteristics
Patient characteristics | Total study population (N = 196) | Adherent sample (N = 100) | Non-adherent sample (N = 96) |
---|---|---|---|
N (%) or mean ± SD | N (%) or mean ± SD | N (%) or mean ± SD | |
Age (years) | 71.0 ± 10.6 | 71.4 ± 10.2 | 70.5 ± 11.0 |
Gender
| |||
Male | 100 (51.0) | 54 (54.0) | 46 (47.9) |
Origin
| |||
Dutch | 176 (89.8) | 93 (93.0) | 83 (86.5) |
Education
| |||
Low | 47 (24.0) | 21 (21.0) | 26 (27.1) |
Moderate | 56 (28.6) | 29 (29.0) | 27 (28.1) |
High | 93 (47.4) | 50 (50.0) | 43 (44.8) |
Employment status
a
| |||
Employed | 53 (21.9) | 23 (23.0) | 20 (20.8) |
Volunteer | 15 (7.7) | 7 (7.0) | 8 (8.3) |
Retired | 129 (65.8) | 66 (66.0) | 63 (65.6) |
Unemployed/disabled | 19 (9.7) | 9 (9.0) | 10 (10.4) |
Living situation
| |||
With others | 145 (74.0) | 75 (75.0) | 70 (72.9) |
Assistance with medication use
| |||
Yes | 22 (11.2) | 12 (12.0) | 10 (10.4) |
No. of prescribed medicines
b,c
| |||
≥ 4 | 133 (67.9) | 59 (60.2) | 74 (79.6) |
Impact of medicines use on daily life
Total study population (N = 196) | Adherent patients (N = 100) | Non-adherent patients (N = 96) | p valuea | |
---|---|---|---|---|
Mean ± SD | Mean ± SD | Mean ± SD | ||
Sum score (range 42–210) | 93.1 ± 13.6 | 93.2 ± 13.3 | 93.0 ± 14.0 | 0.931 |
Theme scores
| ||||
1 Patient–doctor relationships and communication about medicines (9–45) | 19.8 ± 4.6 | 19.8 ± 4.0 | 19.8 ± 5.2 | 0.985 |
2 Interferences with daily life (8–40) | 17.7 ± 4.4 | 17.7 ± 4.5 | 17.8 ± 4.3 | 0.909 |
3 Practicalities (7–35) | 13.3 ± 3.7 | 13.3 ± 3.8 | 13.3 ± 3.6 | 0.989 |
4 Effectiveness (4–20) | 8.9 ± 2.3 | 9.0 ± 2.2 | 8.9 ± 2.4 | 0.743 |
5 Patient–pharmacist communication about medicines (3–15) | 6.2 ± 1.8 | 6.2 ± 1.7 | 6.2 ± 1.8 | 0.848 |
6 Acceptance of medicine use (4–20) | 8.3 ± 2.7 | 8.3 ± 2.5 | 8.3 ± 2.9 | 0.960 |
7 Autonomy/control over medicine use (4–20) | 12.8 ± 2.8 | 13.1 ± 2.9 | 12.5 ± 2.8 | 0.157 |
8 Concerns about potential harm (3–15) | 8.4 ± 2.7 | 8.1 ± 2.8 | 8.6 ± 2.6 | 0.179 |
Total study population (N = 196) | Adherent sample (N = 100) | Non-adherent sample (N = 96) | Odds ratio (95% CI) | p valuea | |
---|---|---|---|---|---|
Agree or strongly agree N (%) | Agree or strongly agree N (%) | Agree or strongly agree N (%) | |||
Theme 1 Patient–doctor relationships and communication about medicines | |||||
My doctor(s) listens to my opinions and concerns about my medicines | 142 (72.4) | 74 (74.0) | 68 (70.8) | 0.85 (0.46–1.60) | 0.620 |
The information my doctor(s) gives me about my medicines is useful | 170 (86.7) | 88 (88.0) | 82 (85.4) | 0.80 (0.35–1.83) | 0.595 |
My doctor(s) spends enough time discussing my medicines with me | 146 (74.5) | 78 (78.0) | 68 (70.8) | 0.69 (0.36–1.31) | 0.251 |
I am confident speaking to my doctor(s) about my medicines | 145 (74.0) | 76 (76.0) | 69 (71.9) | 0.81 (0.43–1.53) | 0.511 |
My doctor(s) takes my concerns of side effects seriously | 113 (57.7) | 56 (56.0) | 57 (59.4) | 1.15 (0.65–2.03) | 0.633 |
I understand what my doctor(s) tells me about my medicines | 169 (86.2) | 87 (87.0) | 82 (85.4) | 0.88 (0.39–1.97) | 0.748 |
The health professionals providing my care know enough about me and my medicines | 125 (63.8) | 65 (65.0) | 60 (62.5) | 0.90 (0.50–1.61) | 0.716 |
I trust the judgement of my doctor(s) in choosing medicines for me | 149 (76.0) | 74 (74.0) | 75 (78.1) | 1.26 (0.65–2.43) | 0.499 |
There is enough sharing of information about my medicines between professionals providing my care | 86 (43.9) | 43 (43.0) | 43 (44.8) | 1.08 (0.61–1.89) | 0.801 |
Theme 2 Interferences with daily life
| |||||
Taking medicines interferes with my social life | 45 (23.0) | 26 (26.0) | 19 (19.8) | 0.70 (0.36–1.38) | 0.303 |
Taking medicines causes problems with daily tasks | 17 (8.7) | 6 (6.0) | 11 (11.5) | 2.03 (0.72–5.72) | 0.182 |
The medicines I use have an adverse effect on the holidays I can take | 8 (4.1) | 6 (6.0) | 2 (2.1) | 0.33 (0.07–1.69) | 0.185 |
My life revolves around using my medicines | 55 (28.1) | 27 (27.0) | 28 (29.2) | 1.11 (0.60–2.08) | 0.736 |
Taking medicines affects my driving ability | 8 (4.1) | 5 (5.0) | 3 (3.1) | 0.61 (0.14–2.64) | 0.511 |
I have to put a lot of planning and thought into taking my medicines | 10 (5.1) | 3 (3.0) | 7 (7.3) | 2.54 (0.634–0.14) | 0.186 |
I worry that I have to take several medicines at the same time | 16 (8.2) | 8 (8.0) | 8 (8.3) | 1.05 (0.38–2.91) | 0.932 |
Changes in daily routine cause problems with my medicines | 41 (20.9) | 23 (23.0) | 18 (18.8) | 0.77 (0.39–1.54) | 0.465 |
Theme 3 Practicalities
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It is difficult to identify which medicine is which | 20 (10.2) | 11 (11.0) | 9 (9.4) | 0.84 (0.33–2.12) | 0.707 |
The instructions on my medicines are easy to follow | 187 (95.4) | 94 (94.0) | 93 (96.9) | 1.98 (0.48–8.15) | 0.345 |
I find opening the packaging of my medicines difficult | 28 (14.3) | 17 (17.0) | 11 (11.5) | 0.63 (0.28–1.43) | 0.270 |
I find getting my prescriptions from the doctor difficult | 14 (7.1) | 6 (6.0) | 8 (8.3) | 1.42 (0.48–4.27) | 0.528 |
I find getting my medicines from the pharmacist difficult | 11 (5.6) | 6 (6.0) | 5 (5.2) | 0.86 (0.25–2.92) | 0.810 |
I find using my medicines difficult | 21 (10.7) | 5 (5.0) | 16 (16.7) | 3.80 (1.33–10.83) | 0.012* |
It is easy to keep to my medicines routine | 171 (87.2) | 89 (89.0) | 82 (85.4) | 0.72 (0.31–1.68) | 0.454 |
Theme 4 Effectiveness
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I am satisfied with the effectiveness of my medicines | 131 (66.8) | 67 (67.0) | 64 (66.7) | 0.99 (0.54–1.79) | 0.960 |
My medicines live up to my expectations | 131 (66.8) | 67 (67.0) | 64 (66.7) | 0.99 (0.54–1.79) | 0.960 |
My medicines are working | 157 (80.1) | 82 (82.0) | 75 (78.1) | 0.78 (0.39–1.58) | 0.498 |
My medicines prevent my condition getting worse | 126 (64.3) | 60 (60.0) | 66 (68.8) | 1.47 (0.81–2.64) | 0.202 |
Theme 5 Patient–pharmacist communication about medicines | |||||
The information my pharmacist gives me about my medicines is useful | 162 (82.7) | 82 (82.0) | 80 (83.3) | 1.10 (0.52–2.30) | 0.805 |
I am confident speaking to my pharmacist about my medicines | 127 (64.8) | 65 (65.0) | 62 (64.6) | 0.98 (0.55–1.77) | 0.951 |
I understand what my pharmacist tells me about my medicines | 166 (84.7) | 81 (81.0) | 85 (88.5) | 1.81 (0.81–4.04) | 0.146 |
Theme 6 Acceptance of medicine use
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Taking medicines is routine for me | 146 (74.5) | 73 (73.0) | 73 (76.0) | 1.17 (0.62–2.24) | 0.625 |
I accept that I have to take medicines long term | 151 (77.0) | 76 (76.0) | 75 (78.1) | 1.13 (0.58–2.20) | 0.724 |
My medicines are important to me | 179 (91.3) | 90 (90.0) | 89 (92.7) | 1.41 (0.52–3.88) | 0.502 |
My medicines allow me to live my life as I want to | 128 (65.3) | 72 (72.0) | 56 (58.3) | 0.54 (0.30–0.99) | 0.046* |
Theme 7 Autonomy/control over medicine use
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I can vary the dose of the medicines I take | 19 (9.7) | 9 (9.0) | 10 (10.4) | 1.18 (0.46–3.03) | 0.738 |
I can change the times I take my medicines if I want to | 101 (51.5) | 44 (44.0) | 57 (59.4) | 1.86 (1.06–3.28) | 0.032* |
I can choose whether or not to take my medicines | 67 (34.2) | 29 (29.0) | 38 (39.6) | 1.60 (0.89–2.91) | 0.120 |
I can adapt my medicine-taking to my lifestyle | 83 (42.3) | 43 (43.0) | 40 (41.7) | 0.95 (0.54–1.67) | 0.856 |
Theme 8 Concerns about potential harm
| |||||
I am concerned about experiencing side effects | 79 (40.3) | 34 (34.0) | 45 (46.9) | 1.71 (0.96–3.05) | 0.067 |
I am concerned about possible damaging long-term effects of taking medicines | 78 (39.8) | 36 (36.0) | 42 (43.8) | 1.38 (0.78–2.46) | 0.286 |
I worry that my medicines may interact with each other | 20 (10.2) | 10 (10.0) | 10 (10.4) | 1.05 (0.42–2.64) | 0.923 |