Skip to main content
SpringerLink
Log in

Factors associated with adherence to drug therapy: a population-based study

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

To investigate adherence to prescription in a female population aged 35–65 years.

Design

Postal questionnaire study of 2991 randomly sampled 35- to 64-year-old women in seven provinces of central Sweden.

Methods

The study was performed in 1995 as a cross-sectional postal questionnaire study in seven counties in central Sweden. The questionnaire was sent to a random sample of 4200 women between the ages of 35 and 64, of whom 2991 (71.2%) responded. The questionnaire asked about drugs prescribed during the past year and about factors potentially affecting adherence.

Results

The same women had different degrees of adherence to different medications. A large number of factors were associated with adherence. Multivariate analysis revealed that age, scheduled check-up, perceived importance of medication, concerns about medication safety and taking medication for a respiratory or a cardiovascular disease were significantly related to adherence. Adherence ranged from 15–98% depending on these factors, and was the lowest among young women who regarded their medication as unimportant and who had no scheduled check-up; the highest reported adherence was found among elderly women who regarded their medication as important and who had a scheduled check-up.

Conclusion

Factors that were associated with the perceived importance of medication had a positive effect on adherence, while concerns about medication safety had a negative effect.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Andrade SE, Walker AM, Gottlieb LK, Hollenberg NK, Testa MA, Saperia GM, Platt R (1995) Discontinuation of antihyperlipidemic drugs -Do rates reported in clinical trial reflect rates in primary care settings? N Engl J Med 332:1125–1231

    Article  PubMed  CAS  Google Scholar 

  2. Aspegren K (1999) Teaching and learning communication skills in medicine-a review with quality grading of articles. Med Teach 21:563–570

    Article  Google Scholar 

  3. Bardel A, Wallander MA, Svärdsudd K (2000) Reported current use of prescription drugs and some of its determinants among 35 to 65-year-old women in mid-Sweden: A population-based study. J Clin Epidemiol 53:637–643

    Article  PubMed  CAS  Google Scholar 

  4. Bloom BS (1998) Continuation of initial antihypertensive medication after 1 year of therapy. Clin Ther 20:671–681

    Article  PubMed  CAS  Google Scholar 

  5. Boethius G (1977) The recording of drug prescriptions in the county of Jämtland. Acta Med Scand 202:241–251

    Article  PubMed  CAS  Google Scholar 

  6. Carter WB, Inui TS, Kukull W, Haig VH (1982) Outcome-based doctor-patient interaction analysis: II. Identifying effective provider and patient behaviour. Med Care 20:550–566

    Article  PubMed  CAS  Google Scholar 

  7. Cramer JA, Scheyer RD, Mattson RH (1990) Compliance declines between clinic visits. Arch Intern Med 150:1509–1510

    Article  PubMed  CAS  Google Scholar 

  8. Eagle K, Kline-Rogers E, Goodman SG, Gurfinkel EP, Avezum A, Flather MD, Granger CB, Erickson S, White K, Steg PG (2004) Adherence to evidence-based therapies after discharge for acute coronary syndromes. An ongoing, prospective, observational study. Am J Med 117:73–81

    Article  PubMed  Google Scholar 

  9. Farmer KC (1999) Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther 21:1074–1090

    Article  PubMed  CAS  Google Scholar 

  10. Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB (2004) The concordance of self-report with other measure of medication adherence a summary of the literature. Med Care 42:649–652

    Article  PubMed  Google Scholar 

  11. Grant RW, Devita NG, Singer DE, Meigs JB (2003) Polypharmacy and medication adherence in patients with type 2 diabetes. Diabetes Care 26:51408–1412

    PubMed  Google Scholar 

  12. Harlow SD, Linet MS (1989) Agreement between questionnaire data and medical records. The evidence for accuracy of recall. Am J Epidemiol 129:223–248

    Google Scholar 

  13. Haynes RB, Taylor DW, Sachett D, Gibson ES, Bernholz CD, Murkherjee J (1980) Can simple clinical measurements detect patient noncompliance? Hypertension 2:757–764

    PubMed  CAS  Google Scholar 

  14. Haynes RB, McKibbon KA, Kanani R (1996) Systematic review off randomised trails of interventions to assist patients to follow prescriptions for medications. Lancet 348:383–386

    Article  PubMed  CAS  Google Scholar 

  15. Horne R, Weinman J (1999) Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 47:555–567

    Article  PubMed  CAS  Google Scholar 

  16. Insull W (1997) The problem of compliance to cholesterol altering therapy. J Int Med 241:317–325

    Article  CAS  Google Scholar 

  17. Jackevicius CA, Mamdani M, Tu JV (2002) Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA 288:462–467

    Article  PubMed  Google Scholar 

  18. JMP User’s guide (2000) SAS Institute Cary, N.C.

  19. Kiortsis DN, Giral P, Bruckert E, Turpin G (2000) Factors associated with low compliance with lipid-lowering drugs in hyperlipidemic patients. J Clin Pharm Ther 25:445–451

    Article  PubMed  CAS  Google Scholar 

  20. Laidlaw TS, MacLeod H, Kaufman DM, Langille DB, Sargeant J (2002) Implementing a communication skills program in medical school: needs assessment and programme change. Med Educ 36:115–124

    Article  PubMed  Google Scholar 

  21. Lindgren R, Berg G, Hammar M, Zuccon E (1993) Hormonal replacement therapy and sexuality in a population of Swedish postmenopausal women. Acta Obst Gynecol Scand 72:292–297

    CAS  Google Scholar 

  22. Loiseau P, Marchal C (1988) Determinants of compliance in epileptic patients. Epilepsy Res Suppl 1:135–140

    PubMed  CAS  Google Scholar 

  23. Matsui D, Hermann C, Klein J, Berkovitch M, Olivieri N, Koren G (1994) Critical comparison of novel and existing methods of compliance assessment during a clinical trial of an oral iron chelator. J Clin Pharmacol 34:944–949

    PubMed  CAS  Google Scholar 

  24. Popa-Lisseanu MGG, Greisinger A, Richardson M, O’Malley KJ, Janssen NM, Marcus DM, Tagore J, Suarez-Almazor M (2005) Determinants of treatment. Adherence in ethnically diverse, economically disadvantaged patients with rheumatic disease. J Rheumatol 32:913–928

    Google Scholar 

  25. Richter A, Anton SF, Koch P, Dennett S (2003) The impact of reducing dose frequency on health outcomes. Clin Ther 25:2307–2335

    Article  PubMed  Google Scholar 

  26. Roter DL (1989) Which facets of communication have strong effect on outcome – a meta-analysis. In: Stewart MA, Roter DL (eds) Communication with medical patients. Sage Publ, Newbury Park

    Google Scholar 

  27. Schroeder K, Fahey T, Ebrahim S (2004) How can we improve adherence to blood-pressure lowering medication in ambulatory care? Arch Intern Med 164:722–732

    Article  PubMed  Google Scholar 

  28. Senior V, Marteau TM, Weinman J (2004) Genetic risk assessment for FH Trial (Grafts) Study Group. Self-reported adherence to cholesterol-lowering medication in patients with familial hypercolesterolaemia: the role of illness perceptions. Cardiovasc Drug Ther 18:475–481

    Article  Google Scholar 

  29. Sewitch MJ, Dobkin PL, Bernatsky S, Baron M, Starr M, Cohen M, Fitzcharles MA (2004) Medication non-adherence in women with fibromyalgia. Rheumatology (Oxford) 43:648–654

    Article  CAS  Google Scholar 

  30. Sidel J, Ryan K, Nemis-White J (1998) Shaping the healthcare environment through evidence-based medicine: A case study of the ICONS project. Hosp Quart 2:29–33

    CAS  Google Scholar 

  31. Statistical Analysis System (1995) Statistical Analysis System. SAS Institute, Cary, N.C.

  32. Stewart MA (1984) What is a successful doctor-patient interview? A study of interactions and outcomes. Soc Sci Med 19:167–175

    Article  PubMed  CAS  Google Scholar 

  33. Tibblin G, Tibblin B, Peciva S, Kullman S, Svärdsudd K (1990) The Göteborg Quality of Life Instrument-an assessement of well-being and symptoms among men born in 1913 and 1923, methods and validity. Scand J Prim Health Care Suppl 1:33–38

  34. Wahl C, Gregoire JP, Teo K, Beaulieu M, Labelle S, Leduc B, Cochrane B, Lapointe L, Montague T (2005) Concordance, compliance and adherence in healthcare: closing gaps and improving outcomes. Healthcare Q 8:65–70

    Google Scholar 

  35. Van den Brandt PA, Petri H, Dorant E, Goldbohm RA, Van de Crommert S (1991) Comparison of questionnaire information and pharmacy data on drug use. Pharm Weekblad 13:91–96

    Google Scholar 

  36. Vlasnik J, Aliotta S, DeLor B (2005) Medication adherence: Factors influencing compliance with prescribed medication plans. Case Manager 16:47–51

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by grants from The Swedish Foundation for Health Care Sciences and Allergy Research, from the Epidemiology Department of AstraZeneca R&D Mölndal and from Uppsala University.

Author information

Authors and Affiliations

  1. Family Medicine and Clinical Epidemiology Section, Department of Public Health and Caring Sciences, Uppsala Science Park, 751 85, Uppsala, Sweden

    Annika Bardel, Mari-Ann Wallander & Kurt Svärdsudd

  2. Department of Epidemiology, AstraZeneca R&D Mölndal, Mölndal, Sweden

    Mari-Ann Wallander

Authors
  1. Annika Bardel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mari-Ann Wallander
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kurt Svärdsudd
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Annika Bardel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bardel, A., Wallander, MA. & Svärdsudd, K. Factors associated with adherence to drug therapy: a population-based study. Eur J Clin Pharmacol 63, 307–314 (2007). https://doi.org/10.1007/s00228-006-0246-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-006-0246-4

Keywords

Search

Navigation