[Patients'adherence-related beliefs about medicines prescribed for long-term conditions in HIV patients]

Farm Hosp. 2015 Jan 1;39(1):23-8. doi: 10.7399/fh.2015.39.1.8127.
[Article in Spanish]

Abstract

Purpose: To assess adherence and beliefs about long-term medicines for other chronic conditions among HIV-infected patients as well as to evaluate their relationship.

Method: A cross-sectional study was conducted from may to july 2014 in HIV-infected patients treated with antiretroviral treatment (ART) and ≥1 long-term medicines for other chronic diseases. The variables analysed in the study were demographics: sex, age, education, employment status, living situation; clinical: mode of transmission, HIV plasma viral load, T-CD4+, CDC classification; and pharmacotherapeutics: type of ART, adherence to long-term medicines for other chronic conditions using the 4-item Morisky Medication Adherence (MMAS) Scale. MMAS scores were dichotomised into adherent/non-adherent. The Beliefs about Medicines Questionnaires (BMQ) was used to assess patients' beliefs about the long-term medicines. The BMQ-Specific has two scales (necessity and concern) with five questions each that uses a 5-point Likert scale. Internal consistency within BMQ scales was measured with Cronbach's α and their association with adherence was assessed with t-Student tests, using SPSS 20.0.

Results: We included 126 patients (80.4% male, mean age 49.0 ± 8.3). The mean of long-term medicines was 2.9 ± 2.0. The percentage of non-adherent patients was 54.0%. 63.5% of patients had AIDS, that showed statistically significant relationship with non-adherence. Concerns were negatively related to self-reported adherence (14.6 ± 5.7 vs. 12.1 ± 6.1; p=0.019). No relationship between adherence and necessity was found (17.3 ± 5.6 vs. 18.8 ± 4.4; p=0.188). Internal consistency for BMQ-Specific was high (Cronbach's α=0.724).

Conclusion: Higher concerns are associated with higher self-reported adherence to long-term medicines in HIV infected-patients.

Objetivo: Determinar a adherencia y las creencias hacia la medicacion para patologias cronicas concomitantemente prescrita al TAR en pacientes infectados por el VIH, asi como determinar si existen diferencias significativas en las creencias entre los pacientes adherentes y no adherentes al los tratamientos concomitantes al TAR. Método: Estudio transversal llevado a cabo durante mayo y julio 2014 en pacientes VIH+ con tratamiento antirretroviral y uno o mas medicamentos para patologias cronicas. Se recogieron variables sociodemograficas: edad, sexo, educacion, situacion laboral, si vivia solo; clinicas: modo de transmision de la infeccion, carga viral plasmatica, T-CD4, estadio; y farmacoterapeuticas: tipo de tratamiento antirretroviral, comedicacion y adherencia a esta mediante el cuestionario Morisky. Se midieron las creencias hacia dicha comedicacion mediante el Beliefs about Medicines Questionnare (BMQ), que incluye dos escalas, necesidad y preocupacion. Los datos se analizaron con SPSSR 20.0. Se aplico la prueba t de Student. La fiabilidad del cuestionario se estimo mediante el alfa de Cronbach. Resultados: Se incluyeron 126 pacientes (80.4% hombres, 49}8.3 anos). El numero de medicamentos concomitantes fue 2.9}2.0. Se clasifico como no adherente al 54.0%. El 63.5% tenia sida, que se identifico como una variable independiente predictora de no adherencia. Las diferencias en la escala de preocupacion entre los pacientes no adherentes y adherentes fue estadisticamente significativa (14.6}5.7 vs. 12.1}6.1; p=0.019), mientras que en aquellas relativas a la necesidad no hubo diferencias (17.3}5.6 vs. 18.8}4.4; p=0.188). La fiabilidad del BMQ-especifico, asi como de las escalas de necesidad y preocupacion, fue buena (0.724, 0.794, 0.785, respectivamente). Conclusiones: Los pacientes VIH positivos con otras patologias cronicas no adherentes presentan creencias negativas relacionadas con la preocupacion en cuanto a la comedicacion.

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Cross-Sectional Studies
  • Culture
  • Female
  • HIV Infections / complications*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult