Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in Pharmacokinetics
Carlos De las Cuevas,1,2 Jose de Leon3– 5 1Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain; 2Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San Cristóbal...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-10-01
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| Series: | Patient Preference and Adherence |
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| Online Access: | https://www.dovepress.com/self-report-for-measuring-and-predicting-medication-adherence-expertsr-peer-reviewed-article-PPA |
| _version_ | 1819018566533382144 |
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| author | De las Cuevas C de Leon J |
| author_facet | De las Cuevas C de Leon J |
| author_sort | De las Cuevas C |
| collection | DOAJ |
| description | Carlos De las Cuevas,1,2 Jose de Leon3– 5 1Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain; 2Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San Cristóbal de La Laguna, Spain; 3Mental Health Research Center at Eastern State Hospital, Lexington, KY, USA; 4Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain; 5Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apóstol Hospital, University of the Basque Country, Vitoria, SpainCorrespondence: Carlos De las CuevasDepartment of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna,, Campus de Ofra s/n, San Cristóbal de La Laguna, Canary Islands, SpainTel +34-922-316502Fax +34-922-319353Email ccuevas@ull.edu.esThe Problem: Poor adherence to appropriately prescribed medication is a global challenge for psychiatrists.Prior Studies: Measuring adherence is complicated. In our recent three-country naturalistic study including more than 1000 patients and their adherence to multiple medication prescriptions at the same time, patients’ self-report of adherence to each specific drug was the only practical option for measuring adherence. Systematic literature reviews provide inconsistent results for sociodemographic, clinical and medication variables as predictors of adherence to psychiatric drugs. Our studies over the last 10 years in relatively stable psychiatric outpatients have shown that some self-reported health beliefs had consistent, strong effects and a better predictive role. Three dimensions of these health beliefs are characteristics of the individual: 1) attitudes toward psychiatric medication such as pharmacophobia (fear of taking drugs or medicines), 2) health locus of control (the belief patients have about who or what agent determines the state of their health), 3) psychological reactance (an emotional reaction in direct contradiction to rules or regulations that threaten or suppress certain freedoms in behavior). They can be measured by the Patient Health Beliefs Questionnaire on Psychiatric Treatment. The attitude toward each specific medication can be measured by the necessity-concern framework and summarized as the presence or absence of skepticism about that drug. After 25 years conducting pharmacokinetic studies in psychiatric drugs, particularly antipsychotics, we have limited understanding of how to use blood levels to predict the effects of non-adherence or to establish it.Expert Opinion on Future Studies: Future studies to predict adherence should include the inpatient setting and explore insight. Studying the pharmacokinetics associated with non-adherence in each psychiatric drug is a major challenge. Medication adherence is a complex and dynamic process changing over time in the same patient. Personalizing adherence using psychological or pharmacological variables are in their initial stages.Keywords: attitude to health, drug monitoring, health behavior, medication adherence, psychiatry, psychopharmacology |
| first_indexed | 2024-12-21T03:21:27Z |
| format | Article |
| id | doaj.art-04a6e835054a47e8ac1516a4a40bc840 |
| institution | Directory Open Access Journal |
| issn | 1177-889X |
| language | English |
| last_indexed | 2024-12-21T03:21:27Z |
| publishDate | 2020-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Patient Preference and Adherence |
| spelling | doaj.art-04a6e835054a47e8ac1516a4a40bc8402022-12-21T19:17:41ZengDove Medical PressPatient Preference and Adherence1177-889X2020-10-01Volume 141823184257888Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in PharmacokineticsDe las Cuevas Cde Leon JCarlos De las Cuevas,1,2 Jose de Leon3– 5 1Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain; 2Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San Cristóbal de La Laguna, Spain; 3Mental Health Research Center at Eastern State Hospital, Lexington, KY, USA; 4Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain; 5Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apóstol Hospital, University of the Basque Country, Vitoria, SpainCorrespondence: Carlos De las CuevasDepartment of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna,, Campus de Ofra s/n, San Cristóbal de La Laguna, Canary Islands, SpainTel +34-922-316502Fax +34-922-319353Email ccuevas@ull.edu.esThe Problem: Poor adherence to appropriately prescribed medication is a global challenge for psychiatrists.Prior Studies: Measuring adherence is complicated. In our recent three-country naturalistic study including more than 1000 patients and their adherence to multiple medication prescriptions at the same time, patients’ self-report of adherence to each specific drug was the only practical option for measuring adherence. Systematic literature reviews provide inconsistent results for sociodemographic, clinical and medication variables as predictors of adherence to psychiatric drugs. Our studies over the last 10 years in relatively stable psychiatric outpatients have shown that some self-reported health beliefs had consistent, strong effects and a better predictive role. Three dimensions of these health beliefs are characteristics of the individual: 1) attitudes toward psychiatric medication such as pharmacophobia (fear of taking drugs or medicines), 2) health locus of control (the belief patients have about who or what agent determines the state of their health), 3) psychological reactance (an emotional reaction in direct contradiction to rules or regulations that threaten or suppress certain freedoms in behavior). They can be measured by the Patient Health Beliefs Questionnaire on Psychiatric Treatment. The attitude toward each specific medication can be measured by the necessity-concern framework and summarized as the presence or absence of skepticism about that drug. After 25 years conducting pharmacokinetic studies in psychiatric drugs, particularly antipsychotics, we have limited understanding of how to use blood levels to predict the effects of non-adherence or to establish it.Expert Opinion on Future Studies: Future studies to predict adherence should include the inpatient setting and explore insight. Studying the pharmacokinetics associated with non-adherence in each psychiatric drug is a major challenge. Medication adherence is a complex and dynamic process changing over time in the same patient. Personalizing adherence using psychological or pharmacological variables are in their initial stages.Keywords: attitude to health, drug monitoring, health behavior, medication adherence, psychiatry, psychopharmacologyhttps://www.dovepress.com/self-report-for-measuring-and-predicting-medication-adherence-expertsr-peer-reviewed-article-PPAattitude to healthdrug monitoringhealth behaviormedication adherencepsychiatrypsychopharmacology |
| spellingShingle | De las Cuevas C de Leon J Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in Pharmacokinetics Patient Preference and Adherence attitude to health drug monitoring health behavior medication adherence psychiatry psychopharmacology |
| title | Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in Pharmacokinetics |
| title_full | Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in Pharmacokinetics |
| title_fullStr | Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in Pharmacokinetics |
| title_full_unstemmed | Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in Pharmacokinetics |
| title_short | Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in Pharmacokinetics |
| title_sort | self report for measuring and predicting medication adherence experts rsquo experience in predicting adherence in stable psychiatric outpatients and in pharmacokinetics |
| topic | attitude to health drug monitoring health behavior medication adherence psychiatry psychopharmacology |
| url | https://www.dovepress.com/self-report-for-measuring-and-predicting-medication-adherence-expertsr-peer-reviewed-article-PPA |
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