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Psychol Health. 2017 Oct;32(10):1233-1248. doi: 10.1080/08870446.2016.1275632. Epub 2017 Jan 2.

Assessing adherence to multiple medications and in daily life among patients with multimorbidity.

Author information

1
a Department of Psychology , Columbia University , New York , NY , USA.
2
b Department of Psychology , University of Zurich , Zurich , Switzerland.
3
c Center of Competence Multimorbidity, University of Zurich , Zurich , Switzerland.
4
g University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich , Zurich , Switzerland.
5
d Department of Psychology , University of Geneva , Geneva , Switzerland.
6
h Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva , Geneva , Switzerland.
7
i Swiss National Center of Competences in Research LIVES-Overcoming Vulnerability: Life Course Perspectives , Lausanne , Switzerland.
8
e Cantonal Hospital Olten , Olten , Switzerland.
9
f Department of Internal Medicine , University Hospital Zurich , Zurich , Switzerland.

Abstract

OBJECTIVE:

Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity).

DESIGN:

Eighty-four patients with multimorbidity and multiple-medication regimens completed three monthly panel questionnaires. A randomly assigned subsample additionally completed a 30-day daily diary.

MAIN OUTCOME MEASURE:

The Non-Adherence Report; a brief self-report measure of adherence to each prescribed medication (NAR-M), and in daily life. We further assessed the Medication Adherence Report Scale (MARS), and a subsample of participants were randomised to electronic adherence monitoring.

RESULTS:

The NAR-M indicated M = 94.7% adherence at Time 1 (SD = 9.3%). The NAR-M was significantly correlated with the MARS (rt1 = .52, rt2 = .57, and rt3 = .65; p < .001), and in tendency with electronically assessed adherence (rt2 = .45, rt3 = .46, p < .10). Variance components analysis indicated that between-person differences accounted for 10.2% of the variance in NAR-M adherence rates, whereas 22.9% were attributable to medication by person interactions.

CONCLUSION:

This study highlights the importance and feasibility of studying adherence to multiple medications differentially, and in daily life. Future studies may use these measures to investigate within-person and between-medication differences in adherence.

KEYWORDS:

electronic medication adherence; multimorbidity; multiple chronic conditions; multiple medications; polypharmacy; self-report

PMID:
28043163
DOI:
10.1080/08870446.2016.1275632
[Indexed for MEDLINE]

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