Factors Associated with Medication Non-Adherence among Patients with Lifestyle-Related Non-Communicable Diseases
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Sample Size
2.3. Measures
2.3.1. Demographic Data
2.3.2. Health Locus of Control (HLC)
2.3.3. Unintentional and Intentional Non-Adherence
2.3.4. Trouble Taking Medication
2.4. Data Analysis
2.5. Ethical Considerations
3. Results
3.1. Unintentional and Intentional Non-Adherence, HLC, Lifestyle Habits, and Trouble Taking Medication by Age Group
3.2. Correlations between Unintentional and Intentional Non-Adherence and Types of HLC by Age
3.3. Unintentional and Intentional Non-Adherence, Lifestyle Habits, and Trouble Taking Medication by Age
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Item | Dimension * | |
---|---|---|
1 | To stay healthy, it is good to pray hard and respect one’s ancestors. | S |
2 | I am healthy because I am lucky. | C |
3 | I take responsibility for my health. | I |
4 | Things that affect your health usually happen by chance. | C |
5 | I got sick because an undesired ghost possessed me. | S |
6 | Whether or not I recover from an illness depends on the warm support of my friends and family. | F |
7 | To stay healthy, I must pay attention to myself. | I |
8 | I got sick due to an ancestor’s undesirable fate. | S |
9 | Even if I feel sick, I only need a doctor. | Pr |
10 | Whether or not my illness improves will depend on my attitude. | I |
11 | If I donate to the gods and Buddha and ask for my safety, they will protect me from illnesses. | S |
12 | How long until my illness gets better depends on my luck. | C |
13 | It is thanks to God that I can stay healthy. | S |
14 | The improvement in my illness depends on my physician. | Pr |
15 | When I get sick, compassion from my family and others leads to recovery. | F |
16 | Whether or not I recover from a disease depends on my own efforts. | I |
17 | Whether or not the disease gets better depends on fate. | C |
18 | I am healthy because of my family’s compassion. | F |
19 | The improvement in the disease depends on the doctor’s judgment. | Pr |
20 | Whether or not I recover from my illness depends on whether there is someone who can help me. | F |
21 | How well I feel depends on my doctor’s skill. | Pr |
22 | It is a coincidence that I got sick. | C |
23 | Thanks to medical progress, I am staying healthy. | Pr |
24 | It is up to me to stay healthy. | I |
25 | Whether or not I will recover from my illness depends on the cooperation of my family. | F |
Unintentional Non-Adherence | |
---|---|
Item | |
1 | Please tell us how often you can imagine yourself having a hard time doing what your doctor suggested you to do. |
2 | Please tell us how often you can imagine yourself being unable to do what was necessary to follow your doctor’s treatment plans. |
3 | Please tell us how often you can imagine yourself forgetting to take your medications. |
4 | Please tell us how often you can imagine yourself missing taking your medications because you were away from home or busy with other things. |
Intentional Non-Adherence | |
Item | |
1 | Please tell us how often you can imagine yourself missing taking your medications because you seemed to need less medicine. |
2 | Please tell us how often you can imagine yourself missing taking your medications because you didn’t believe in the treatment your doctor was recommending. |
3 | Please tell us how often you can imagine yourself missing taking your medications because you wanted to avoid side effects or felt like the drug was toxic or harmful. |
4 | Please tell us how often you can imagine yourself missing taking your medications because you wanted to try alternative therapies (e.g., herbalist, homeopathic, or acupuncture treatments). |
5 | Please tell us how often you can imagine yourself missing taking your medications because the medication was too expensive. |
20–59 Years (n = 246) | Over 60 Years (n = 353) | p | |||
---|---|---|---|---|---|
Age (years) | Mean (SD) | 46.1(10.1) | 66.5(3.9) | ||
Sex | Male | N (%) | 151(61.4) | 202(57.2) | 0.313 |
Female | N (%) | 95(38.6) | 151(42.8) | ||
Diagnosed with lifestyle-related NCDs | Hypertension | N (%) | 130(52.8) | 221(62.6) | 0.018 |
Diabetes | N (%) | 75(30.5) | 63(17.8) | <0.001 | |
Dyslipidemia | N (%) | 99(40.2) | 130(36.8) | 0.442 | |
Gout | N (%) | 62(25.2) | 51(14.4) | 0.001 | |
Heart disease | N (%) | 52(21.1) | 55(15.6) | 0.084 | |
Cerebrovascular disease | N (%) | 39(15.9) | 29(8.2) | 0.006 | |
Cancer | N (%) | 52(21.1) | 64(18.1) | 0.401 |
Total (n = 599) | 20–59 Years (n = 246) | Over 60 Years (n = 353) | ||
---|---|---|---|---|
Adherence (a) | ||||
Unintentional non-adherence | Mean (SD) | 15.7 (3.3) | 13.9 (4.0) | 16.0 (2.9) |
p | <0.001 | |||
Intentional non-adherence | Mean (SD) | 21.5 (3.9) | 19.8 (5.5) | 22.4 (3.3) |
p | <0.001 | |||
HLC (a) | ||||
Supernatural | Mean (SD) | 13.1 (5.8) | 13.5 (6.1) | 11.8 (5.0) |
p | 0.001 | |||
Internal | Mean (SD) | 21.0 (4.3) | 20.7 (5.0) | 22.0 (3.6) |
p | 0.001 | |||
Chance | Mean (SD) | 16.7 (4.6) | 16.5 (4.9) | 15.6 (4.5) |
p | 0.034 | |||
Family | Mean (SD) | 18.7 (4.2) | 18.4 (4.8) | 19.3 (3.6) |
p | 0.012 | |||
Professional | Mean (SD) | 18.0 (4.0) | 18.0 (4.7) | 18.4 (3.6) |
p | 0.269 | |||
Lifestyle (b) | ||||
Alcohol consumption (over three days a week) | N (%) | 255 (42.6) | 102 (41.5) | 153 (43.3) |
p | 0.675 | |||
Current smoker | N (%) | 130 (21.7) | 70 (28.5) | 60 (17.0) |
p | 0.001 | |||
I feel I do not sleep enough | N (%) | 170 (28.4) | 90 (36.6) | 80 (22.7) |
p | <0.001 | |||
I do not care about my eating habits | N (%) | 169 (28.2) | 89 (36.2) | 80 (22.7) |
p | <0.001 | |||
I do not exercise | N (%) | 249 (41.6) | 106 (43.1) | 143 (40.5) |
p | 0.556 | |||
Trouble taking medication (b) | ||||
I have experienced side effects | N (%) | 173 (28.9) | 91 (37.0) | 82 (23.2) |
p | <0.001 | |||
Sometimes the medicine is hard for me to swallow | N (%) | 96 (16.0) | 58 (23.6) | 38 (10.8) |
p | <0.001 | |||
Sometimes I cannot handle medicine tools * | N (%) | 39 (6.5) | 30 (12.2) | 9 (2.5) |
p | <0.001 | |||
Sometimes I cannot hear what a healthcare professional says | N (%) | 48 (8.0) | 28 (11.4) | 20 (5.7) |
p | 0.014 | |||
Sometimes I feel the explanations from doctors and pharmacists are difficult to understand | N (%) | 66 (11.0) | 38 (15.4) | 28 (7.9) |
p | 0.005 | |||
Sometimes I forget what my doctor or pharmacist told me | N (%) | 59 (9.9) | 43 (17.5) | 16 (4.5) |
p | <0.001 | |||
I find it difficult to organize my medicines | N (%) | 82 (13.7) | 44 (17.9) | 38 (10.8) |
p | 0.015 |
Supernatural | Internal | Chance | Family | Professional | |
---|---|---|---|---|---|
20–59 years (n = 246) | |||||
Unintentional non-adherence | −0.083 | 0.274 ** | −0.016 | 0.154 * | 0.101 |
Intentional non-adherence | −0.191 ** | 0.396 ** | −0.037 | 0.196 * | 0.160 * |
Over 60 years (n = 353) | |||||
Unintentional non-adherence | −0.106 * | 0.170 ** | −0.164 ** | 0.01 | 0.037 |
Intentional non-adherence | −0.222 ** | 0.232 ** | −0.172 ** | 0.03 | 0.051 |
Unintentional Non-Adherence | Intentional Non-Adherence | |||||||
---|---|---|---|---|---|---|---|---|
20–59 Years (n = 246) | Over 60 Years (n = 353) | 20–59 Years (n = 246) | Over 60 Years (n = 353) | |||||
β | p | β | p | β | p | β | p | |
Lifestyle | ||||||||
Alcohol consumption (over three days a week) | 0.110 | 0.079 | 0.034 | 0.524 | 0.147 | 0.020 | 0.059 | 0.275 |
Current smoker | 0.280 | <0.001 | 0.068 | 0.212 | 0.172 | 0.007 | 0.064 | 0.242 |
I do not care about my eating habits | −0.114 | 0.074 | 0.009 | 0.870 | −0.136 | 0.034 | 0.042 | 0.442 |
I feel I do not sleep enough | −0.011 | 0.859 | 0.164 | 0.002 | −0.055 | 0.374 | 0.091 | 0.089 |
I do not exercise | −0.102 | 0.115 | 0.050 | 0.355 | −0.151 | 0.020 | −0.005 | 0.920 |
Adjusted R2 * | 0.141 | 0.026 | 0.136 | 0.006 | ||||
Trouble taking medication | ||||||||
I have experienced side effects | 0.150 | 0.009 | 0.141 | 0.005 | 0.104 | 0.080 | 0.117 | 0.022 |
Sometimes the medicine is hard for me to swallow | 0.183 | 0.003 | 0.134 | 0.017 | 0.002 | 0.972 | 0.103 | 0.069 |
Sometimes I cannot handle medicine tools | 0.045 | 0.552 | −0.050 | 0.363 | 0.120 | 0.130 | 0.040 | 0.477 |
Sometimes I cannot hear what a healthcare professional says | 0.245 | 0.004 | −0.014 | 0.780 | 0.336 | <0.001 | 0.041 | 0.421 |
Sometimes I feel the explanations from doctors and pharmacists are difficult to understand | −0.001 | 0.983 | 0.101 | 0.046 | 0.080 | 0.255 | −0.030 | 0.556 |
Sometimes I forget what my doctor or pharmacist told me | 0.147 | 0.035 | 0.305 | <0.001 | 0.009 | 0.896 | 0.338 | <0.001 |
I find it difficult to organize my medicines | 0.132 | 0.039 | 0.077 | 0.173 | 0.164 | 0.014 | 0.035 | 0.542 |
Adjusted R2 * | 0.468 | 0.228 | 0.429 | 0.210 |
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Nakajima, R.; Watanabe, F.; Kamei, M. Factors Associated with Medication Non-Adherence among Patients with Lifestyle-Related Non-Communicable Diseases. Pharmacy 2021, 9, 90. https://doi.org/10.3390/pharmacy9020090
Nakajima R, Watanabe F, Kamei M. Factors Associated with Medication Non-Adherence among Patients with Lifestyle-Related Non-Communicable Diseases. Pharmacy. 2021; 9(2):90. https://doi.org/10.3390/pharmacy9020090
Chicago/Turabian StyleNakajima, Rie, Fumiyuki Watanabe, and Miwako Kamei. 2021. "Factors Associated with Medication Non-Adherence among Patients with Lifestyle-Related Non-Communicable Diseases" Pharmacy 9, no. 2: 90. https://doi.org/10.3390/pharmacy9020090
APA StyleNakajima, R., Watanabe, F., & Kamei, M. (2021). Factors Associated with Medication Non-Adherence among Patients with Lifestyle-Related Non-Communicable Diseases. Pharmacy, 9(2), 90. https://doi.org/10.3390/pharmacy9020090