Abstract
This cross-sectional study aimed to describe the association between medication experiences and beliefs and self-reported medication adherence in patients with chronic diseases in two different samples from two different societies: the USA and the Sultanate of Oman. The Morisky Medication Adherence Score (MMAS-8) questionnaire was used to measure medication adherence. Three items (statements) were used for measuring medication experiences and beliefs variable on a four-point Likert scale adapted from the 2015 National Consumer Survey of the Medication Experience and Pharmacists’ Role (NCSME&PR). In the U.S., quantitative secondary data analysis of 13,731 participants was conducted using the 2015 NCSME&PR, a self-administered online survey coordinated by Qualtrics Panels between 28 April 2015 and 22 June 2015. The same variables were translated into Arabic, with studies conducted at the Royal Court Medical Center in Oman, and data from 714 participants were collected between 16 June 2019 and 16 August 2019. Data were analyzed using IMB/SPSS version 24.0 software. Chi-square analysis and descriptive statistics were used. The results showed that the low adherence rates for medication (MMAS-8 < 6) were 56% and 52% in Omani and U.S. groups, respectively. Approximately 90% of the U.S. and Omani participants believed that “medicines are a life-saver”; however, medication adherence was higher in Oman (30%) than in the United States (9%) for these participants. In total, 60% of the U.S. and 29% of Omani participants believed that “medicines are a burden”; however, about 60–65% of participants in both countries were in the low medication adherence group. Additionally, 63% of the U.S. and 83% of the Omani participants disagreed that “medicines do more harm than good”; however, medication adherence in the U.S. (15%) was higher than in Oman (8%). In conclusion, a decrease in low medication adherence was observed with positive medication experiences and beliefs. However, the impacts of medication experiences and beliefs on low medication adherence rates were different from one population to another. The “medication burden” statement resulted in the highest percentage of difference in terms of low medication adherence rates between those who agree and those who disagree in the U.S. group (20%), whereas the “medicines are a life-saver” statement resulted in a greater difference in the Omani group (30%). Proper communication between patients and healthcare providers based on the patient’s medication experiences and beliefs will substantially improve medication adherence.
Highlights
Medication adherence, which is defined as “the degree to which a person’s behavior corresponds with the agreed recommendations from a healthcare provider” [1], has been one of the most central topics in healthcare for decades and is still the case today [2,3,4]
Study Measures (Variables) This study aimed to describe the association between medication experiences and beliefs and self-reported medication adherence in patients with chronic diseases in two different societies: the USA and the Sultanate of Oman
Descriptive results for medication experiences and beliefs, chronic diseases, medication adherence, age, gender, and educational level for U.S and Omani participants are summarized in Table 1 below
Summary
Medication adherence, which is defined as “the degree to which a person’s behavior corresponds with the agreed recommendations from a healthcare provider” [1], has been one of the most central topics in healthcare for decades and is still the case today [2,3,4]. Non-adherence negatively impacts the health of millions of Americans and costs billions of dollars annually. In the United States, around 3% to 10% of avoidable healthcare costs annually ($100–$300 billion) are attributed to non-adherence [5]. About 133 million people, representing more than 40% of the U.S population, have one or more chronic diseases [6]. Diabetes, breathing problems, cancer, stroke, and arthritis are the most common chronic diseases in the United States [7]. Adherence to medications for treating chronic conditions is a significant problem in healthcare, which has substantially impacted clinical outcomes and healthcare expenditure.Treating people with chronic diseases costs around 90% ($3.5 trillion) of the nation’s healthcare costs annually [7]. Medication adherence is generally low, at around 50% to 65% on average [10,11]
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