Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
The influence of gender and psychological distress on adherence to prescribed medication
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. Högskolan i Gävle. (Farmakoepidemiologi)
2014 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The lack of adherence to drug therapy is a major problem; it can contribute to significant deterioration of disease and increased health-care costs. Improving medication adherence is a big challenge; there is no simple solution to the problem. It is thus essential to improve our knowledge of non-adherence (NA) and its causes.

Aims: The aims of the thesis were to study the influence of gender and psychological distress on self-reported, intentional and unintentional non-adherent behaviour, and to investigate the reasons for NA.

Methods: A population-based study that included a postal questionnaire was carried out in a cross-section of the general Swedish population (n=7,985, aged 18-84 years). The response rate was 61.1% (n=4,875) and current prescription drug use was reported by 2,802 participants. The questionnaire covered use of prescription drugs, NA to the drug regimens, reasons for NA, economic status, attitudes to drugs, and the presence of somatic or mental problems, and also included the Hospital Anxiety and Depression Scale questionnaire.

Results: The results showed differences in various self-reported non-adherent behaviour patterns and reasons for NA between the genders. In most cases, these remained after controlling for confounders such as socioeconomic factors and attitudes to drugs that are known to differ between women and men. Associations were also found between symptoms of anxiety and/or depression and the presence of intentional or unintentional non-adherent behaviour (with a stronger average association for intentional NA), and between anxiety/depression and some of the reasons given for NA, e.g. adverse drug reactions (ADRs).

Conclusions: Although it was not possible to confirm causal relationships, this thesis emphasises the effects of gender and psychological distress on NA. In summary, both gender and anxiety and/or depression influenced non-adherent behaviour and the reasons given for NA. For instance, ADRs seemed to influence the decision not to take the drug as prescribed, especially among women and participants under psychological distress. It is suggested that a deep understanding of the causes of NA and of the impact of gender and psychological distress on the outcomes would help those aiming to improve adherence to prescribed medication.

Place, publisher, year, edition, pages
Uppsala: Faculty of Pharmacy, Uppsala University , 2014. , 41 p.
Keyword [en]
medication adherence, reasons, attitudes, gender, anxiety symptoms, depression symptoms
National Category
Medical and Health Sciences
Research subject
Pharmacoepidemiology
Identifiers
URN: urn:nbn:se:uu:diva-236731OAI: oai:DiVA.org:uu-236731DiVA: diva2:765266
Presentation
2014-03-12, Öbrinkrummet, BMC, Husargatan 3, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-11-25 Created: 2014-11-21 Last updated: 2014-11-25Bibliographically approved
List of papers
1. Women and men report different behaviours in, and reasons for medication non-adherence: a nationwide Swedish survey
Open this publication in new window or tab >>Women and men report different behaviours in, and reasons for medication non-adherence: a nationwide Swedish survey
2012 (English)In: Pharmacy Practice, ISSN 1885-642X, E-ISSN 1886-3655, Vol. 10, no 4, 207-221 p.Article in journal (Refereed) Published
Abstract [en]

Objectives

The aim of the present study was to analyse gender differences in self-reported non-adherence (NA) to prescribed medication in the Swedish general population. We aimed to study unintentional and intentional NA as well as the reasons given for NA.

Methods

A questionnaire was mailed to a cross-sectional, random, national sample of people aged 18-84 years in Sweden (n=7985). The response rate was 61.1% (n=4875). The questionnaire covered use of prescription drugs, NA behaviourand reasons for NA.

Results

Use of prescription drugs was reported by 59.5% (n=2802) of the participants, and 66.4% (n=1860) of these participants did not adhere to the prescribed regimen. No overall gender differences in reporting NA were found. However, when analysing the various types of NA behaviour and the reasons for NA, different gender patterns emerged. Men were more likely to report forgetting [OR 0.77 (95% CI 0.65:0.92)], changing the dosage [OR 0.64 (95% CI 0.52:0.79)] and that they had recovered [14.3%, (OR 0.71 (95% CI 0.56:0.90)] as a reason. In contrast, more women than men reported filling the prescription but not taking the drug [OR 1.25 (95% CI 1.02:1.54)] and reported the development of adverse drug reactions (ADRs) [OR 1.89 (95% CI 1.37:2.59)] as a reason more commonly. The gender differences remained, in most cases, after controlling for confounders such as age, socioeconomic factors, medical problems and attitudes toward drugs.

Conclusions

Women and men have different patterns of NA behaviour and different reasons for NA. Therefore, if adherence is to be improved, a wide knowledge of all the reasons for NA is required, along with an understanding of the impact of gender on the outcomes.

 

Keyword
Medication Adherence, Health knowledge, Attitudes, Practice, Health care surveys, Sweden
National Category
Pharmaceutical Sciences
Research subject
Pharmacoepidemiology
Identifiers
urn:nbn:se:uu:diva-193611 (URN)
Available from: 2013-02-05 Created: 2013-02-05 Last updated: 2017-12-06Bibliographically approved
2. The influence of symptoms of anxiety and depression on medication nonadherence and its causes: a population based survey of prescription drug users in Sweden
Open this publication in new window or tab >>The influence of symptoms of anxiety and depression on medication nonadherence and its causes: a population based survey of prescription drug users in Sweden
2013 (English)In: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 7, 805-811 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this study was to evaluate the associations between self-reported symptoms of anxiety and/or depression, nonadherent (NA) behaviors, and reasons for NA to medication regimens.

Methods: A population based cross-sectional study with questionnaire was performed in the general Swedish population. The participants were 2802 prescription drug users aged 18-84 years. The questionnaire covered use of prescription drugs, symptoms of anxiety and/or depression, based on the Hospital Anxiety and Depression Scale (HADS), various NA behavior types, intentional and unintentional, and various reasons for NA.

Results: Symptoms of anxiety and depression, independently and in combination, were associated with unintentional and intentional NA, with a stronger association with intentional NA. Regarding the reasons given for NA, for example anxiety, independently or in combination with depression, was associated with a fear of developing adverse drug reactions (ADRs). Depression, independently or in combination with anxiety, on the other hand, was associated with the actual development of ADRs.

Conclusion: A cross-sectional design such as this does not allow assessment of causality derived from the results. However, the results indicate that patients experiencing symptoms of psychological distress are at increased risk of NA, especially intentional NA, and could therefore benefit from extra attention from the health care professional. Patients with symptoms of anxiety and/or depression should be identified and monitored for the development and/or fear of ADRs, in order to improve adherence to medication regimens.

Keyword
Medication Adherence, Anxiety symptoms, Depression symptoms, Reasons
National Category
Medical and Health Sciences
Research subject
Pharmacoepidemiology
Identifiers
urn:nbn:se:uu:diva-205574 (URN)10.2147/PPA.S50055 (DOI)000323147600001 ()
Available from: 2013-08-20 Created: 2013-08-20 Last updated: 2017-12-06Bibliographically approved

Open Access in DiVA

fulltext(550 kB)197 downloads
File information
File name FULLTEXT02.pdfFile size 550 kBChecksum SHA-512
99e08407d93c293e659b12088a2a52a2fa07e34d25c9434278e951a70717c3825b0d077c812251c3a8f9ac15a0403f67e53626ef741b4afc14cb92c8253bc043
Type fulltextMimetype application/pdf

Authority records BETA

Thunander Sundbom, Lena

Search in DiVA

By author/editor
Thunander Sundbom, Lena
By organisation
Department of Pharmacy
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 197 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

urn-nbn

Altmetric score

urn-nbn
Total: 1022 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf