The influence of patients’ knowledge on adherence to their chronic medications: a cross-sectional study in Jordan (original) (raw)

Abstract

Background Non-adherence to long-term therapy for chronic illnesses is considered the major reason why patients fail to reach their clinical goals, resulting in suboptimal health outcomes, death, and extra costs on the health care systems. Knowledge about the disease and prescription medications, an understanding of the reason the medication is needed, and good expectations or attitudes toward treatment, all contribute to a better medication-taking behavior and are associated with higher rates of adherence. Objective This study examines the relationship between knowledge and adherence of patients receiving long-term therapy for one or more chronic illnesses in Jordan. Settings The study was conducted in the out-patient clinics of two Jordanian hospitals (The University of Jordan Hospital and Jordan Hospital). Methods This was a cross-sectional study that included 902 patients. The correlation between patients’ knowledge about their chronic medications and adherence was assessed. Effects of several sociodemographic characteristics were investigated in regard to knowledge and adherence. Main outcome measures Knowledge was assessed by a modified version of the McPherson index, and the Morisky Medication Adherence Scale was used to assess medication adherence. Results A significant correlation was found between patients’ knowledge and their adherence to medications (r = 0.357, p < 0.001). Most of the participants had low adherence. Younger age, higher education levels, high income, fewer medications and diseases were significant predictors of higher knowledge levels. Knowledgeable patients were found to be twice as likely to have moderate-to-high adherence as their unknowledgeable counterparts. Similarly, high income and higher education were associated with higher adherence scores. Conclusion Forgetfulness and aversion toward medications were the most common barriers to medication adherence. This implicates that clinicians and health care policy makers should direct their effort toward two main strategies to improve adherence increasing awareness and education of effective ways to remind patients about their medications.

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References

  1. De Geest S, Sabate E. Adherence to long-term therapies: evidence for action. Eur J Cardiovasc Nurs. 2003;2(4):323.
    Article PubMed Google Scholar
  2. McCarthy R. The price you pay for the drug not taken. Bus Health. 1998; 16(10): 27-8, 30, 2-3.
  3. Bosworth HB, Granger BB, Mendys P, Brindis R, Burkholder R, Czajkowski SM, et al. Medication adherence: a call for action. Am Heart J. 2011;162(3):412–24.
    Article PubMed Central PubMed Google Scholar
  4. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–97.
    Article CAS PubMed Google Scholar
  5. Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26(5):331–42.
    Article CAS PubMed Google Scholar
  6. Hope CJ, Wu J, Tu W, Young J, Murray MD. Association of medication adherence, knowledge, and skills with emergency department visits by adults 50 years or older with congestive heart failure. Am J Health Syst Pharm. 2004;61(19):2043–9.
    PubMed Google Scholar
  7. Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005;43(6):521–30.
    Article PubMed Google Scholar
  8. Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc. 2011;86(4):304–14.
    Article PubMed Central PubMed Google Scholar
  9. Gadkari AS, McHorney CA. Unintentional non-adherence to chronic prescription medications: how unintentional is it really? BMC Health Serv Res. 2012;12:98.
    Article PubMed Central PubMed Google Scholar
  10. Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;2:CD000011.
    PubMed Google Scholar
  11. Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on patients. Am J Med. 2012;125(9):882–7.
    Article PubMed Google Scholar
  12. Jin J, Sklar GE, Oh VMS, Li SC. Factors affecting therapeutic compliance: a review from the patient’s perspective. Ther Clin Risk Manag. 2008;4(1):269–86.
    PubMed Central PubMed Google Scholar
  13. Okuyan B, Sancar M, Izzettin FV, Morisky DE. Erratum to and corrections on the article entitled “Assessment of medication knowledge and adherence among patients under oral chronic medication treatment in community pharmacy settings”. Pharmacoepidemiol Drug Saf. 2013;22(2):218–20.
    Article PubMed Google Scholar
  14. Barber N, Parsons J, Clifford S, Darracott R, Horne R. Patients’ problems with new medication for chronic conditions. Qual Saf Health Care. 2004;13(3):172–5.
    Article PubMed Central CAS PubMed Google Scholar
  15. Quinlan P, Price KO, Magid SK, Lyman S, Mandl LA, Stone PW. The relationship among health literacy, health knowledge, and adherence to treatment in patients with rheumatoid arthritis. HSS J. 2013;9(1):42–9.
    Article PubMed Central PubMed Google Scholar
  16. Sweileh WM, Zyoud SH, Abu Nab’a RJ, Deleq MI, Enaia MI, Nassar SM, et al. Influence of patients’ disease knowledge and beliefs about medicines on medication adherence: findings from a cross-sectional survey among patients with type 2 diabetes mellitus in Palestine. BMC Public Health. 2014;14:94.
    Article PubMed Central PubMed Google Scholar
  17. McPherson ML, Smith SW, Powers A, Zuckerman IH. Association between diabetes patients’ knowledge about medications and their blood glucose control. Res Social Adm Pharm. 2008;4(1):37–45.
    Article PubMed Google Scholar
  18. Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complicat. 2010;24(2):84–9.
    Article PubMed Google Scholar
  19. Sweileh WM, Ihbesheh MS, Jarar IS, Sawalha AF, Abu Taha AS, Zyoud SH, et al. Antipsychotic medication adherence and satisfaction among Palestinian people with schizophrenia. Curr Clin Pharmacol. 2012;7(1):49–55.
    Article CAS PubMed Google Scholar
  20. Alhalaiqa F, Deane KH, Nawafleh AH, Clark A, Gray R. Adherence therapy for medication non-compliant patients with hypertension: a randomised controlled trial. J Hum Hypertens. 2012;26(2):117–26.
    Article PubMed Central CAS PubMed Google Scholar
  21. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. 2008;10(5):348–54.
    Article Google Scholar
  22. Aburuz SM, Bulatova NR, Yousef AM, Al-Ghazawi MA, Alawwa IA, Al-Saleh A. Comprehensive assessment of treatment related problems in hospitalized medicine patients in Jordan. Int J Clin Pharm. 2011;33(3):501–11.
    Article PubMed Google Scholar
  23. Basheti IA, Qunaibi EA, Bulatova NR, Samara S, AbuRuz S. Treatment related problems for outpatients with chronic diseases in Jordan: the value of home medication reviews. Int J Clin Pharm. 2013;35(1):92–100.
    Article PubMed Google Scholar
  24. Aljumah K, Ahmad Hassali A, AlQhatani S. Examining the relationship between adherence and satisfaction with antidepressant treatment. Neuropsychiatr Dis Treat. 2014;10:1433–8.
    Article PubMed Central PubMed Google Scholar
  25. Cantudo-Cuenca MR, Jimenez-Galan R, Almeida-Gonzalez CV, Morillo-Verdugo R. Concurrent use of comedications reduces adherence to antiretroviral therapy among HIV-infected patients. J Manag Care Pharm. 2014;20(8):844–50.
    Google Scholar
  26. Fabbrini G, Abbruzzese G, Barone P, Antonini A, Tinazzi M, Castegnaro G, et al. Adherence to anti-Parkinson drug therapy in the “REASON” sample of Italian patients with Parkinson’s disease: the linguistic validation of the Italian version of the “Morisky Medical Adherence Scale-8 items”. Neurol Sci. 2013;34(11):2015–22.
    Article CAS PubMed Google Scholar
  27. Jarab AS, Alqudah SG, Mukattash TL, Shattat G, Al-Qirim T. Randomized controlled trial of clinical pharmacy management of patients with type 2 diabetes in an outpatient diabetes clinic in Jordan. J Manag Care Pharm. 2012;18(7):516–26.
    PubMed Google Scholar
  28. Garcia-Perez LE, Alvarez M, Dilla T, Gil-Guillen V, Orozco-Beltran D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013;4(2):175–94.
    Article PubMed Central PubMed Google Scholar
  29. Lee GK, Wang HH, Liu KQ, Cheung Y, Morisky DE, Wong MC. Determinants of medication adherence to antihypertensive medications among a Chinese population using Morisky Medication Adherence Scale. PLoS ONE. 2013;8(4):e62775.
    Article PubMed Central CAS PubMed Google Scholar

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Acknowledgments

The authors are grateful the logistic support from the Deanship of Academic Research at the University of Jordan, the University of Jordan Hospital, and the Jordan Hospital.

Funding

The authors are grateful for the financial support from the Deanship of Academic Research at the University of Jordan.

Conflicts of interests

None.

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Authors and Affiliations

  1. The University of Jordan, Amman, Jordan
    Oriana Awwad, Amal Akour & Suha Al-Muhaissen
  2. UCLA Fielding School of Public Health, Los Angeles, CA, USA
    Donald Morisky

Authors

  1. Oriana Awwad
  2. Amal Akour
  3. Suha Al-Muhaissen
  4. Donald Morisky

Corresponding author

Correspondence toOriana Awwad.

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Awwad, O., Akour, A., Al-Muhaissen, S. et al. The influence of patients’ knowledge on adherence to their chronic medications: a cross-sectional study in Jordan.Int J Clin Pharm 37, 504–510 (2015). https://doi.org/10.1007/s11096-015-0086-3

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