Beliefs About Medicines Questionnaire Research Articles

OA40 Clinical and psychological factors associated with adherence based on a patient self-reported questionnaire: results from the biologics in rheumatoid arthritis genetics and genomics study syndicate (BRAGGS) cohort

Abstract Background/Aims To explore the relationship of clinical and psychological factors with adherence based on a patient self-reported questionnaire from a prospective longitudinal study of patients receiving TNFi biologic treatment for rheumatoid arthritis, recruited since 2008. Methods Analysis of data collected from a prospective longitudinal UK study (Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate [BRAGGSS]) of patients with moderate to severe RA commencing TNFi biologic treatment. Clinical data including Disease Activity Score-28 (DAS28), serological status (Rheumatoid Factor positivity) and body mass index (BMI) were collected. Patients also completed self-reported questionnaires, the health assessment questionnaire (HAQ), hospital anxiety and depression scale (HAD), beliefs about medicine questionnaire (BMQ), brief illness perception score (B-IPQ) and a self-reported adherence questionnaire. Adherence was defined as any deviation from prescribed medication regime such as altering the dose, forgetting a dose, stopping treatment, missing a dose, and taking less than instructed. Associations between demographic and psychological variables and adherence were evaluated using regression models and a multivariable logistic regression model was used to further evaluate associations, controlling for BMI. Results 1,513 patients (75.7% female, age 58.1 [IQR 16.0], disease duration 9.6 ± 9.6 years and pre-treatment DAS28 scores 5.7 ± 0.8) were included. 70% of patients self-reported adherence to their medication. When comparing the different TNFi treatments, etanercept had the lowest levels of adherence at the 3 and 6 month time-points. Adherence was higher in those with older age (β = 0.03, p< 0.01), higher baseline CRP levels (β = 0.01, p= 0.03) and higher necessity beliefs (β = 0.04, p= 0.03). Adherence was lower in those with higher tender joint counts at baseline (β=-0.03, p= 0.04) and 3 months (β = 0.03, p= 0.02) (Table I). These associations persisted after controlling for the effects of BMI using a multivariable logistic model. Conclusion Self-reported adherence was 70% in this BRAGGS population. Factors associated with non-adherence included higher tender joint counts and lower necessity beliefs pre-treatment, which may allow targeting of interventions to optimise adherence in these groups. Disclosure T.K.Y. Chong: None. N. Nair: None. A.W. Morgan: None. J.D. Isaacs: None. A.G. Wilson: None. K.L. Hyrich: Honoraria; Abbvie. Grants/research support; K.H has grants from BMS and Pfizer. D. Plant: None. A. Barton: Grants/research support; A.B has received funding/speaker fees from BMS, Pfizer and Galapagos.

Factors affecting medication adherence in patients using oral chemotherapy: A descriptive study.

The utilization of oral chemotherapy agents for cancer treatment has witnessed a steady rise in recent years. The pivotal determinant for the success of oral chemotherapy lies in the adherence of cancer patients to the prescribed treatment. This study aims to explore oral chemotherapy adherence and identify factors influencing medication adherence among cancer patients. A total of 103 cancer patients participated in this descriptive study. Data were collected using the Oral Chemotherapy Adherence Scale, the Turkish Translation of the Beliefs about Medicines Questionnaire (BMQ-T) and The Functional Living Index-Cancer. Of the participants, 66% reported good adherence to oral chemotherapy. Key findings indicate that access to health services (β = -1.473, p = 0.009), cancer stage (β = -1.570, p = 0.015) and the BMQ-T subscale of General Overuse (β = .696, p = 0.041) were independent predictors of medication adherence. The study observed medication non-adherence in one-third of patients undergoing oral chemotherapy. Primary contributors to non-adherence included difficulties in accessing health services, advanced cancer stage and the belief that drugs are over-recommended by doctors. These results underscore the need for a heightened focus on preventable factors, such as improving access to health services and addressing beliefs about drug overuse, to enhance medication adherence in patients receiving oral chemotherapy.

O36: Patient acceptability and adherence to the COMPASS trial drug recommendations following symptomatic carotid endarterectomy (CEA)

Abstract Introduction The COMPASS trial demonstrated that in patients with atherosclerotic diseases, low-dose rivaroxaban and aspirin provides greater protection against subsequent cardiovascular events than antiplatelet monotherapy (MAPT) alone. Medication adherence is necessary to maximise this benefit and is dependent on patient views. We have assessed this in patients following CEA. Methods Following CEA, the views of 63 patients on the COMPASS drug regime were compared with 54 on MAPT. Views on medications was assessed using the Beliefs about Medicine Questionnaire (BMQ) and drug adherence using the Sidorkiewicz scoring system. Side effects and the incidence of new cardiovascular events were also assessed. Results Both groups had similar age (mean 70.6+/-8.7), gender (M:F 2:1), and deprivation indices. Preoperative co-morbidities were similar between groups, as were intervention indications (TIA or stroke). There was no difference (p<0.05) between the COMPASS drug regime and MAPT in BMQ for “Necessity” (19.6 v 19.1), “Concerns” (11.8v 12.0) or the “Necessity–Concerns differential”(+7.8v+7.1). Drug adherence was similar with the median showing a “High drug adherence”. The incidence of bleeding and drug reaction complications was similar. Numbers of new stroke, ischaemic cardiac events, and peripheral vascular disease diagnoses was similar, as was the combined overall major adverse cardiovascular events (MACE). Conclusions Following CEA, patients’ views on medications and their drug adherence are similar in those on the COMPASS drug regime as on MAPT. We have not identified any patient-related barriers to the use of the COMPASS drug regimen to further reduce cardiovascular events.

Intervention for a correct medication list and medication use in older adults: a non-randomised feasibility study among inpatients and residents during care transitions

Abstract Background Medication discrepancies in care transitions and medication non-adherence are problematic. Few interventions consider the entire process, from the hospital to the patient’s medication use at home. Aim In preparation for randomised controlled trials (RCTs), this study aimed (1) to investigate the feasibility of recruitment and retention of patients, and data collection to reduce medication discrepancies at discharge and improve medication adherence, and (2) to explore the outcomes of the interventions. Method Participants were recruited from a hospital and a residential area. Hospital patients participated in a pharmacist-led intervention to establish a correct medication list upon discharge and a follow-up interview two weeks post-discharge. All participants received a person-centred adherence intervention for three to six months. Discrepancies in the medication lists, the Beliefs about Medicines Questionnaire (BMQ-S), and the Medication Adherence Report Scale (MARS-5) were assessed. Results Of 87 asked to participate, 35 were included, and 12 completed the study. Identifying discrepancies, discussing discrepancies with physicians, and performing follow-up interviews were possible. Conducting the adherence intervention was also possible using individual health plans for medication use. Among the seven hospital patients, 24 discrepancies were found. Discharging physicians agreed that all discrepancies were errors, but only ten were corrected in the discharge information. Ten participants decreased their total BMQ-S concern scores, and seven increased their total MARS-5 scores. Conclusion Based on this study, conducting the two RCTs separately may increase the inclusion rate. Data collection was feasible. Both interventions were feasible in many aspects but need to be optimised in upcoming RCTs.

Research of beliefs about medicines by BMQ scale and related factors in hypertensive patients

Introduction: Hypertension is a chronic disease that requires regular monitoring and treatment. Medication adherence and medication trust assessment play an important role in understanding the underlying causes and developing solutions to improve treatment outcomes for patients. Objective: To assess medication trust in hypertensive patients and to explore the factors associated with medication trust according to the Beliefs about Medicines Questionnaire (BMQ) scale. Methods: A cross-sectional study was conducted on 607 outpatients with hypertension who visited and received treatment at the University of Medicine and Pharmacy of Hue Hospital from July to November 2022. Results: The mean age of patients was 69.7 ±11 years. The proportion of patients who agreed that taking medication is necessary was 99%. Only 3.1% of patients believed that doctors placed too much trust in medication, and about 5.1% believed that medication was harmful. About 62.8% of patients did not fully understand the medications they were taking. Conclusions: We found that medication trust is closely associated with demographic characteristics, disease-related characteristics, knowledge about hypertension, the provision of health information and treatment medications. Key words: beliefs about Medication, hypertension, BMQ scale

Beliefs about Medicines and the Level of Intentional Non-Adherence to Treatment among Patients with Multiple Sclerosis Treated with First-Line Drugs.

Multiple sclerosis (MS) is a chronic inflammatory, demyelinating and neurodegenerative disease of the central nervous system. MS has no curable disease but drug modifying therapy (DMT) can delay the long-term disability progression of the disease. The effectiveness of MS treatment depends on the patient's adherence to therapy. This study evaluated the level of intentional non-adherence and the relationship between beliefs about medication and the level of intentional non-adherence to treatment of patients with multiple sclerosis. A group of 146 patients with relapsing-remitting MS were included. To assess different aspect of adherence, the Intentional Non-Adherence Scale (INAS) was used. For evaluating patients' beliefs and opinions regarding medication, the Beliefs about Medicines Questionnaire (BMQ) was used. The mean total INAS score was 51.41 ± 27.83 points. Patients were most concerned about the necessity to take medication and least concerned about the harm caused by medication. The overuse and harm domains of the BMQ were significantly correlated with INAS scores (p < 0.05). Independent determinant of intentional non-adherence was overuse.

Patient perspectives on treatment and prevention of recurrent urinary tract infections: a focus group study.

We sought to understand factors that are important to patients for the management of recurrent urinary tract infections (UTI) during both an acute episode and for the prevention of future episodes. This was a qualitative study with focus groups in women with recurrent UTIs. Participants filled out information about prior recurrent UTI treatment and the Belief about Medicines Questionnaire (BMQ). Each 90-minute focus group was moderated by a nonphysician psychologist. Line-by-line coding of each transcript by three independent physicians was used to develop emergent concepts and themes using Grounded Theory methodology. Twenty-six women participated in six focus groups. The average age of participants was 62 years and 77% were post-menopausal. All women had already tried multiple prevention strategies for their recurrent UTIs. The average BMQ-specific scores indicated a net positive attitude toward medicines specifically prescribed for recurrent UTI prevention. Several themes emerged from the focus groups. First, patients wanted providers to acknowledge the high burden imposed by frequent interactions with the health care system for the management of recurrent UTI. Second, patients wanted earlier access to providers knowledgeable in the management of this condition. Third, patients wanted to self-manage their condition through a structured treatment plan with support from their providers. Finally, patients wanted greater emphasis on education and prevention strategies to reduce their antibiotic intake. Patients with recurrent UTI want more efficient workflows, a framework that promotes self-management in partnership with their providers, and a greater emphasis on prevention.

THE USAGE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM): PREVALENCE, HEALTH LITERACY, BELIEFS AND SELF-MANAGEMENT AMONG PEOPLE WITH HYPERTENSION IN A RURAL AREA, PAHANG

Complementary and Alternative Medicine (CAM) is believed to have had health benefits in treating hypertension in past decades, especially in rural areas. However, CAM is often not supported by scientific evidence. Thus, awareness of the possible toxicity of CAM in the self-management of health is crucial. This study aims to identify CAM users’ prevalence, beliefs, health literacy, and examine the associated factors for the self-management of hypertension. This cross-sectional study used a set of questionnaires consisting of demographic data, health-related characteristics, the Montana State University CAM Health Literacy Scale, the Hypertension Self-Care Activity Level Effect (H-SCALE), and the Beliefs About Medicine Questionnaire (BMQ). The study employed simple random sampling, and it was conducted in four health clinics located in Jerantut, Pahang, from January 2021 to May 2021. The analysis involved a total of 233 hypertensive patients. The study found that 60.9% (n = 142) of the participants used CAM within the last 12 months to treat hypertension, with herbs (n = 71, 50%) being the most preferred alternative medication. Most of the respondents had adequate health literacy regarding CAM usage (mean 44.50 ± 5.67) and held a positive perception toward CAM with Specific-Necessity (mean 17.61 ± 2.91) higher than Specific-Concern (mean 15.02 ± 3.40). The results showed that 96.1% (n = 224) reported adherence to alcohol cessation, 65.7% (n = 153) reported adherence to taking medication, 62.7% (n = 146) reported adherence to quitting smoking, 39.9% (n = 93) reported adherence to good weight management, 25.3% (n = 59) reported adherence to active physical activity, and only 14.2% (n = 33) reported adherence to take a healthy diet. The results of multiple logistic regression analysis showed that the female gender was linked to non-adherence with taking medication while having higher health literacy was related to greater adherence to medication. The study also found that female gender was associated with non-adherence with quitting smoking, which was accompanied by a higher belief about medication specificnecessity. In contrast, older age was related to better adherence to quitting smoking. Factors such as being female, having longer disease duration, and having higher health literacy were associated with non-adherence with weight management, while having formal education and a stronger belief in the importance of specific medication were linked to greater adherence to weight management. The study found that a higher belief in the importance of specific medication and being female were related to non-adherence with quitting alcohol use. This study may provide a better understanding of CAM usage among people with hypertension with significant concerns over safety and interaction with the standards prescribed treatment. Further intervention is needed to decrease the possibility of complications and optimize self-management of hypertension with the use of CAM.

The impact of trust in healthcare and medication, and beliefs about medication on medication adherence in a Dutch medication-using population

IntroductionTrust in healthcare and medication, defined as feelings of reassurance and confidence in the healthcare system or medication, may be a key prerequisite before engaging in the use of medication. However, earlier studies have focussed on beliefs about medication rather than trust as predictors of medication adherence. This study therefore aims to simultaneously explore the relationship of trust in healthcare, medication and beliefs about medication, with medication adherence. MethodsIn a cross-sectional study, an online questionnaire was sent out to 1500 members of the Dutch Health Care Consumer Panel of Nivel in November 2018. Respondents were asked to grade their level of trust in healthcare and medication (scale 1–10). The Beliefs About Medicines Questionnaire (BMQ) for general and specific medication beliefs was used to address beliefs, the Medication Adherence Report Scale (MARS-5) to measure medication adherence. Data were analysed using structural equation modelling (SEM) with a backward stepwise approach. Out of 753 people that completed the questionnaire, 407 people used prescription medication and were included in the analyses. ResultsA positive association between trust in medication and medication adherence was found (0.044, p < 0.05). BMQ subscales Overuse (−0.083, p < 0.05), Necessity (0.075, p < 0.05) and Concerns (−0.134, p < 0.01) related with medication adherence. BMQ subscale Harm did not relate to medication adherence. ConclusionTrust in medication and beliefs about medication were both individually associated with medication adherence. Healthcare providers should therefore not only focus on patients' medication beliefs, but also on strengthening patients' trust in medication to improve medication adherence.

Evaluation of medication adherence and medication beliefs and their relation with quality of life in osteoporotic patients with and without vertebral fractures: a path analysis

BackgroundOsteoporosis (OP) is a public health problem that causes morbidity and mortality with various complications, especially fractures, negatively affects quality of life (QoL) and creates an economic burden on society. The aim of this study was to investigate the relationships among medication adherence, medication beliefs, QoL in Turkish patients with OP.ResultsThe Medication Adherence Report Scale (MARS) total score was 17 in those with vertebral fractures and 18 in those without vertebral fractures. The total Quality of Life Questionnaire of the European Foundation for Osteoporosis (Qualeffo-41) score was 48.7 in those with vertebral fractures and 35.1 in those without vertebral fractures. Visual analog scale (VAS) of pain scores showed a moderate correlation with every domain of the Qualeffo-41 scores (r = 0.401, r = 0.412, r = 0.391, r = 0.402, r = 0.380, r = 0.387 respectively, P = < 0.001). MARS total score, Beliefs about Medicines Questionnaire (BMQ), and Qualeffo-41 parameters were compared between patients with osteoporotic fractures and without fractures. In patients with a vertebral fracture, the patients Qualeffo-41 scores were higher with every domain and their QoL was more impaired (p < 0.001); but there were no significant differences between patients with osteoporotic fractures and without fractures in terms of MARS total score and BMQ domains. The pathway analysis results showed that general beliefs about drugs is associated with the physical function and social function of statistically significant and general overuse is associated with the pain (β = 1.781; p < 0.001), and general health (β = 1,832; p = 0.039). However, self-reported medication adherence and specific beliefs is not associated with the pain, physical function, social function, general health, and mental function (p > 0.05) of statistically significant.ConclusionsEnhancing positive medication beliefs are a promising approach to improve medication adherence, and in turn, improved diseases self management and better QoL, in OP patients.

The impact of medication belief on adherence to infliximab in patients with Crohn's disease.

Objective: Crohn's disease (CD) is an incurable chronic disease that requires long-term treatment. As an anti-tumor necrosis factor (TNF) agent, Infliximab (IFX) is widely used in the treatment of Crohn's disease, while the adherence is not high. The purpose of this study was to investigate the adherence to IFX among CD patients in China and evaluate the association between medication belief and IFX adherence. Methods: Demographic data, clinical information and patients' medication beliefs were collected using an online questionnaire and reviewing electronic medical records (EMRs). The Beliefs about Medicines Questionnaire (BMQ)-specific was used to assess medication beliefs which contains the BMQ-specific concern score and the BMQ-specific necessity score. An evaluation of adherence factors was conducted using univariate and multidimensional logistic regression analyses. Results: In all, 166 CD patients responded the online questionnaire among which 77 (46.39%) patients had high adherence. The BMQ-specific concern score in patients in low adherence was 30.00 and in high adherence patients was 27.50, and patients with lower BMQ-specific concern score had higher adherence (p = 0.013). The multiple regression analysis showed that the BMQ-specific concern score (OR = 0.940, 95% CI: 0.888-0.996) significantly affected the IFX adherence in CD patients. Otherwise, gender, marital status, time spent on the way (including the waiting time in infusion center) and accommodation to the center were also the influencing factors of adherence. Conclusion: The IFX adherence to CD in China was not high. Medicine concerns may be predictive factor of adherence. Education, the duration of IFX therapy and experience of adverse effects were not significantly associated with IFX adherence. By enhancing knowledge and relieving medicine concerns, we may increase patients' adherence to IFX.

Translation, cultural adaptation and validation of the revised patients’ attitudes towards deprescribing (rPATD) questionnaire in Romanian older adults

BackgroundDeprescribing is part of ensuring appropriate medication use and may reduce medication-related harm. Capturing the beliefs and attitudes of patients towards deprescribing by using a validated tool may support optimizing medication use in practice. ObjectivesTo translate, culturally adapt and validate the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire in Romanian and to investigate the attitudes and beliefs of older adults towards deprescribing. MethodsThe rPATD questionnaire was translated using forward-backward translation into Romanian and culturally adapted. The psychometric properties were evaluated in older adults ≥65 years of age. Structural validity was assessed by item load on factors using an exploratory factor analysis (EFA) which was compared to the original English version and the internal consistency by Cronbach's alpha. Construct validity was evaluated by calculating the Spearman's rank correlation coefficients between the factor scores obtained using the revised version of the Romanian rPATD and scores on the Beliefs about Medicines Questionnaire (BMQ) Specific Concerns Romanian version. Floor and ceiling effect were also examined. ResultsWe translated the questionnaire and administered it to 224 participants (median age 72 years [interquartile range: 68.0; 77.0]). In the EFA individual items loaded onto 4 factors, grouped similarly to the English version (Involvement, Burden, Appropriateness, Concerns about Stopping factors). Two items from each of the Involvement and Appropriateness factors were removed to improve factor loading and avoid cross-loading. The Cronbach's alpha values for the 4 factors ranged between 0.522 and 0.773. The scores for Burden and Concerns about Stopping factors were found to be positively correlated with BMQ Specific Concerns score. We identified a ceiling effect for one of the four factors (Involvement) and no floor effects. ConclusionsThe Romanian rPATD was validated in 4 factor structure similar to the original English questionnaire. The Romanian version of the questionnaire may support the health care professionals in Romania to initiate and support patient-centered deprescribing.

Patients’ Beliefs About Their Cardiovascular Medications After Acute Coronary Syndrome: A Prospective Observational Study

BackgroundAdherence to secondary preventive pharmacotherapy after an acute coronary syndrome (ACS) is generally poor and is associated with recurrent cardiovascular events. Patients’ beliefs about their medications are a strong predictor of intentional nonadherence. MethodsThis prospective, observational study assessed adult patients’ beliefs about their post-ACS medications, using the Beliefs About Medicines Questionnaire (BMQ), and adherence, using the Medication Adherence Report Scale (MARS-5) at St. Paul’s Hospital in Vancouver, Canada during May-December, 2022. The BMQ and MARS-5 were administered in-hospital and at 4 weeks after discharge. Outcomes included difference in BMQ necessity-concerns differential (BMQ-NCD) from hospitalization to 4-week follow-up and factors associated with the BMQ-NCD. ResultsForty-seven participants completed the 4-week follow-up. The mean age was 64 years, and 83% were male. Most presented with a non-ST-segment-elevation ACS. No difference occurred in BMQ-NCD (7.3 vs 6.6, P = 0.29) or MARS-5 scores from discharge to 4 weeks (22.8 vs 23.7, P = 0.06); however, the BMQ specific-necessity subscale score decreased significantly (20.3 vs 18.8, P = 0.002). South Asian and Middle Eastern ethnic origins, compared to European, were associated with a higher BMQ-NCD. Part-time employment and male sex were associated with a lower BMQ-NCD. ConclusionsParticipants held favourable beliefs about their post-ACS medications, which were largely unchanged from hospitalization to 4 weeks postdischarge, except for beliefs about the necessity of taking their medications. Those of European descent, those with part-time employment, and males had the lowest BMQ-NCD. Self-reported adherence was high. Ongoing reassessment of patients’ beliefs about the necessity of taking their post-ACS medications may be warranted to mitigate further decline in BMQ-NCD.

Beliefs about medicines in gout patients: results from the NOR-Gout 2-year study

Objective Adherence to urate-lowering therapy (ULT) in gout is challenging. This longitudinal study aimed to determine 2 year changes in beliefs about medicines during intervention with ULT. Method Patients with a recent gout flare and increased serum urate received a nurse-led ULT intervention with tight control visits and a treatment target. Frequent visits at baseline and 1, 2, 3, 6, 9, 12, and 24 months included the Beliefs about Medicines Questionnaire (BMQ), and demographic and clinical variables. The BMQ subscales on necessity, concerns, overuse, harm, and the necessity–concerns differential were calculated as a measure of whether the patient perceived that necessity outweighed concerns. Results The mean serum urate reduced from 500 mmol/L at baseline to 324 mmol/L at year 2. At years 1 and 2, 85.5% and 78.6% of patients, respectively, were at treatment target. The 2 year mean ± sd BMQ scores increased for the necessity subscale from 17.0 ± 4.4 to 18.9 ± 3.6 (p < 0.001) and decreased for the concerns subscale from 13.4 ± 4.9 to 12.5 ± 2.7 (p = 0.001). The necessity–concerns differential increased from 3.52 to 6.58 (p < 0.001), with a positive change independent of patients achieving treatment targets at 1 or 2 years. BMQ scores were not significantly related to treatment outcomes 1 or 2 years later, and achieving treatment targets did not lead to higher BMQ scores. Conclusion Patient beliefs about medicines improved gradually over 2 years, with increased beliefs in the necessity of medication and reduced concerns, but this improvement was unrelated to better outcomes. Trial Registration ACTRN12618001372279

Video Education Program for Proper use of Inhalation Devices in Elderly COPD Patients.

This research investigated the utility of a QR code-based video pharmaceutical education program to guide the proper use of the inhalation device in elderly chronic obstructive pulmonary disease (COPD) patients. The patients were recruited for this prospective study during a COPD hospitalization, with 96 patients in the control group (CG) receiving conventional hospital care and 93 patients in the intervention group (IG) receiving QR code-based video pharmaceutical education from hospitalization to six months after discharge to improve proper utilization of inhalation technology The outcome measures used to assess the effectiveness of the education program were the COPD Assessment Test (CAT), inhaler use accuracy, inhaler technique score, Beliefs about Medicines Questionnaire (BMQ) score and patient satisfaction. Compared with CG, inhaler use accuracy and inhaler use scores improved in the IG group, while BMQ-Concern and CAT scores were significantly lower (P<0.05). Improvements in patient quality-of-life and satisfaction were reported. This study revealed that the QR code-based video pharmaceutical education program can improve the quality of life and satisfaction of elderly COPD patients.

A patient-driven registry on Behçet's disease: the AIDA for patients pilot project.

This paper describes the creation and preliminary results of a patient-driven registry for the collection of patient-reported outcomes (PROs) and patient-reported experiences (PREs) in Behçet's disease (BD). The project was coordinated by the University of Siena and the Italian patient advocacy organization SIMBA (Associazione Italiana Sindrome e Malattia di Behçet), in the context of the AIDA (AutoInflammatory Diseases Alliance) Network programme. Quality of life, fatigue, socioeconomic impact of the disease and therapeutic adherence were selected as core domains to include in the registry. Respondents were reached via SIMBA communication channels in 167 cases (83.5%) and the AIDA Network affiliated clinical centers in 33 cases (16.5%). The median value of the Behçet's Disease Quality of Life (BDQoL) score was 14 (IQR 11, range 0-30), indicating a medium quality of life, and the median Global Fatigue Index (GFI) was 38.7 (IQR 10.9, range 1-50), expressing a significant level of fatigue. The mean Beliefs about Medicines Questionnaire (BMQ) necessity-concern differential was 0.9 ± 1.1 (range - 1.8-4), showing that the registry participants prioritized necessity belief over concerns to a limited extent. As for the socioeconomic impact of BD, in 104 out of 187 cases (55.6%), patients had to pay from their own pocket for medical exams required to reach the diagnosis. The low family socioeconomic status (p < 0.001), the presence of any major organ involvement (p < 0.031), the presence of gastro-intestinal (p < 0.001), neurological (p = 0.012) and musculoskeletal (p = 0.022) symptoms, recurrent fever (p = 0.002), and headache (p < 0.001) were associated to a higher number of accesses to the healthcare system. Multiple linear regression showed that the BDQoL score could significantly predict the global socioeconomic impact of BD (F = 14.519, OR 1.162 [CI 0.557-1.766], p < 0.001). Preliminary results from the AIDA for Patients BD registry were consistent with data available in the literature, confirming that PROs and PREs could be easily provided by the patient remotely to integrate physician-driven registries with complementary and reliable information.

Relationships between beliefs about statins and non-adherence in inpatients from Northwestern China: a cross-sectional survey.

Background: Studies have identified patients' beliefs about medicines as an important determinant of non-adherence. However, scant data are available on the possible association between patients' beliefs and statin non-adherence among adult patients in China. The objectives of this study are to assess the prevalence of statin non-adherence, and to identify the factors associated with statin non-adherence, especially the association between inpatients' beliefs about statins and non-adherence in a tertiary hospital in the Northwestern China. Methods: A cross-sectional questionnaire-based survey was carried out in the department of cardiology and neurology between February and June 2022. The Beliefs about Medicine Questionnaire (BMQ) was used to assess patients' beliefs about statins. The Adherence to Refills and Medications Scale (ARMS) was used to assess statin adherence. Logistic regression analyses were performed to identify the factors associated with statin non-adherence. Receiver operator characteristic (ROC) was conducted to assess the performance of the logistic regression model in predicting statin non-adherence. Results: A total of 524 inpatients participated and finished the questionnaire, 426 (81.3%) inpatients were non-adherent to statin, and 229 (43.7%) inpatients expressed strong beliefs about the stain treatment necessity, while 246 (47.0%) inpatients expressed strong concerns about the potential negative effects. We found that the low necessity beliefs about statin (adjusted odds ratio [OR] and 95% confidence interval [CI], 1.607 [1.019, 2.532]; p = 0.041), prescribed rosuvastatin (adjusted OR 1.820 [1.124, 2.948]; p = 0.015) and ex-drinker (adjusted OR 0.254 [0.104, 0.620]; p = 0.003) were independent determinants of statin non-adherence. Conclusion: Statin adherence was poor in this study. The findings indicated a significant association between inpatients' lower necessity beliefs and statin non-adherence. More attention should be focused on statin non-adherence in China. Nurses and pharmacists could play an important role in patient education and patient counseling in order to improve medication adherence.

People-centered care and patients' beliefs about medicines and adherence: A cross-sectional study

IntroductionPeople-centered care (PCC) strategies are believed to improve overall health outcomes. Medicines use is essential for the treatment of many patients with chronic conditions. Non-adherence rates are high and result in poor health outcomes, and increased healthcare utilization and costs. This study aimed to explore the relationship between PCC and adherence to medicines for persons with chronic medicines use, as well as the extent to which patients' beliefs about medicines are influenced by their level of perceived PCC. MethodsA cross-sectional survey design was performed with adults using at least 3 chronic medicines per day. To measure the degree of medicines adherence, patients' ideas about medication, and PCC, four validated questionnaires were used: The Medication Adherence Report Scale (MARS-5), Beliefs about medicines questionnaire (BMQ), Client-Centered Care Questionnaire (CCCQ) and the Shared Decision Making Questionnaire (SDM-Q-9). Socio-demographics, health status, and drug-related burden were questioned as potential factors to impact the relationship between PCC and adherence. ResultsA sample of 459 persons participated. The mean score on the CCCQ (adjusted to pharmacotherapy) was 52.7 on 75 (sd = 8.83, range [18–70]). The top 20% scored 60 or more, the 20% lowest scores were 46 or less. Adherence levels were high, with a mean score of 22.6 on 25 on the MARS-5, and 88% scoring 20 or more. An increase in PCC corresponded to a higher chance of medicines adherence (OR 1.07, 95%CI [1.02–1.12]), corrected for age, the burden due to chronic diseases, the impact of side effects on daily life, and participants' beliefs about medicines. PCC showed positive correlations with the necessity of medicines use (r = 0.1, p = 0.016) and the balance between necessity and concerns (r = 0.3, p < 0.001); and negative correlations with levels of concerns (r = −0.3, p < 0.001) and scores on harmfulness (r = −0.3, p < 0.001) and overuse of medicines (r = −0.4, p < 0.001). ConclusionPatients with chronic medicine use perceived an average high level of people-centeredness in the pharmaceutical care they received. This PCC was weakly positively associated with adherence to their medicines. The higher PCC was evaluated, the more patients believed in the necessity of the medicines use and the better the balance between necessity and concerns. The people-centeredness of pharmaceutical care showed several shortcomings and can still be improved. As such, healthcare providers are advised to actively engage in PCC, and not to wait passively for information provided by the patient.

Adherence to Analgesic Drugs and its Associated Factors among Patients with Cancer Pain: A Crosssectional Study in China.

Objectives: Pain is one of the most common and distressing symptoms co-occurring with cancer progression and treatment, and medication adherence plays an important role in achieving good pain control. However, research on medication adherence and influential factors among individuals with cancer pain (CP) is limited in China. The present study aimed to investigate the adherence to analgesics in patients with CP in China and to identify factors that may influence adherence. Methods: A cross-sectional study was conducted from June 2020 to February 2021. Study instruments consisted of a set of validated questionnaires, 5 measurement instruments including the numerical rating scale (NRS), ID-Pain, Morisky Medication Adherence Scale-Chinese validated version (MMAS-C), Beliefs about Medicines Questionnaire (BMQ) - Specific, and the Hospital Anxiety and Depression Scale (HADS). Results: A total of 141 participants with CP including 71 males (50.4%), aged 54.5±15.5 years were surveyed in this study. Overall, 83 patients (58.9%) showed adherence, but 58 patients (41.1%) showed non-adherence to analgesics. The univariate analysis showed that analgesic adherence was associated with pain duration of>3 months, outbreaks of pain in the last 24 hours, presence of side effects, getting analgesics in time, presence of neuropathic pain, stopping analgesics or adjusting dosage by themselves, presence of anxiety and depression, and beliefs about medicines. Moreover, the multivariate logistic regression showed that getting analgesic drugs in time (odds ratio [OR]=5.218, 95% confidence interval [CI] 1.691-16.100) and high BMQ-Necessity (OR=1.907, 95% CI 1.418-2.565) were associated with high adherence, stopping analgesics or adjusting dosage by themselves (OR=7.958, 95% CI 2.443-25.926) and high BMQ-Concern (OR=0.760, 95% CI 0.600-0.964) were more likely to be associated with non-adherence. Conclusion: In view of our findings, it may be critical for individuals to have a better understanding and strong beliefs about their prescribed analgesic drugs. Pain education, counseling and follow-up of patients and their caregivers, and removal of barriers to accessing analgesic drugs could be considered in further intervention strategies.

Community pharmacist-driven interventions in COPD: improving knowledge, attitude and health status

Background: COPD is a chronic condition requiring care from a multidisciplinary team in which pharmacists play an important role. Aim: We aimed to evaluate the impact of structured pharmacist-patient counseling on patient’s knowledge, attitudes about medicines and the impact of COPD on patients’ health status. Methods: A prospective study was conducted in ten community pharmacies. Patients were counseled using detailed approach after completing validated questionnaires. The patients returned to a pharmacy for a follow-up after three months. Four validated questionnaires have been used to assess different aspects of patient’s knowledge about the disease, their attitudes about medicines and the impact of disease on patients’ health status: COPD Assessment Test (CAT), Modified Medical Research Council Dyspnea Scale (mMRC), Bristol COPD Knowledge Questionnaire (BCKQ), and The Beliefs about Medicines Questionnaire (BMQ). Results: Pharmacists recruited 83 COPD patients, from which 73 patients attended a follow-up visit. Before pharmacist intervention, the CAT median score was 20. After counseling, the CAT score decreased to 18 (p&lt;0.05). The highest improvement in patient’s knowledge was observed for inhaled bronchodilators (28.2%), vaccination (25.8%), oral steroids (24.4%), and smoking (24.2%). The median score for necessity increased, whereas the harm and concern median scores considerably decreased (p&lt;0.05). Conclusion: The results showed significant improvements in all aspects covered throughout pharmacist-patient counseling. Based on our results, proactive role of the pharmacist in the care of COPD patients may be beneficial to patients, to physicians and to healthcare: improving care, alleviating the strain on overloaded doctors with containing the costs.