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Women and men report different behaviours in, and reasons for medication non-adherence : a nationwide Swedish survey [Hombres y mujeres comunican diferentes comportamientos y razones para el incumplimiento de la medicación: Encuesta nacional Sueca]
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Pharmacy, University of Uppsala, Uppsala, Sweden.ORCID iD: 0000-0003-4877-506X
Department of Pharmacy, University of Uppsala, Uppsala, Sweden.
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 behaviour and 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.

Place, publisher, year, edition, pages
2012. Vol. 10, no 4, 207-221 p.
Keyword [en]
Medication adherence, Health knowledge, Attitudes, Gender, Sweden
National Category
Other Medical Sciences
Identifiers
URN: urn:nbn:se:hig:diva-13619Scopus ID: 2-s2.0-84871626995OAI: oai:DiVA.org:hig-13619DiVA: diva2:583901
Projects
Drug related problems in Sweden
Available from: 2013-01-08 Created: 2013-01-08 Last updated: 2017-03-01Bibliographically approved
In thesis
1. The influence of gender and psychological distress on adherence to prescribed medication
Open this publication in new window or tab >>The influence of gender and psychological distress on adherence to prescribed medication
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: Uppsala universitet, 2014. 41 p.
Keyword
medication adherence, reasons, attitudes, gender, anxiety symptoms, depression symptoms
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hig:diva-18027 (URN)
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: 2014-11-28Bibliographically approved

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