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Mucherino S, Maffoni M, Cena C, Armando LG, Guastavigna M, Orlando V, Orofino G, Traina S, Giardini A, Menditto E, The Collaborative Working Group. Italian Translation and Validation of the Original ABC Taxonomy for Medication Adherence. Healthcare (Basel) 2023; 11:846. [PMID: 36981503 PMCID: PMC10048001 DOI: 10.3390/healthcare11060846] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023] Open
Abstract
Medication adherence represents a complex and multifaceted process. Standardized terminology is essential to enable a reproducible process in various languages. The study's aim was to translate and adapt the original Ascertaining Barriers for Compliance (ABC) Taxonomy on medication adherence, first proposed in 2012, into Italian language. The study was carried out according to the Preferred Methods for Translation of the ABC Taxonomy for Medication Adherence adopted by the ESPACOMP. Key steps included: (1) a systematic literature review using PubMed and Embase according to the PRISMA Guidelines to identify published Italian terms and definitions, and Italian adherence experts; (2) a forward translation of terms and definitions; (3) panelists' selection; (4) a three-round Delphi survey. From the systematic review, 19 studies allowed detection of 4 terms, 4 definitions and 767 Italian experts. To these, Italian ESPACOMP members and experts though snowball sampling were added. The identified Italian adherence experts received the Delphi questionnaire. The Italian ABC Taxonomy was achieved after three rounds of Delphi survey by reaching at least a moderate consensus on unambiguous naming and definition of medication adherence-related terms. The Taxonomy is intended to be used in research, academic, and professional fields in order to harmonize adherence terminology and avoid confusion in comparing research findings.
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Affiliation(s)
- Sara Mucherino
- CIRFF, Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
| | - Marina Maffoni
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Clara Cena
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy
| | | | - Marta Guastavigna
- S.C. Malattie Infettive e Tropicali I, ASL Città di Torino, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Valentina Orlando
- CIRFF, Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
| | - Giancarlo Orofino
- S.C. Malattie Infettive e Tropicali I, ASL Città di Torino, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Sara Traina
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy
| | - Anna Giardini
- Information Technology, Istituti Clinici Scientifici Maugeri IRCCS Pavia, 27100 Pavia, Italy
| | - Enrica Menditto
- CIRFF, Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
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Psychosocial and behavioral correlates of self-efficacy in treatment adherence
in older patients with comorbid hypertension and type 2 diabetes. HEALTH PSYCHOLOGY REPORT 2023. [DOI: 10.5114/hpr/159284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
BackgroundAdhering to clinical prescriptions is known to protect against the effects of uncontrolled hypertension and of acute and chronic cardiovascular diseases, including diabetes. Contextually, positive associations between self-care behaviors and psychological constructs, such as self-efficacy, are widely acknowledged in the literature. However, still little is known about the psychological factors underlying the patient’s self-efficacy. This study aimed to investigate the psychosocial and behavioral correlates of self-efficacy related to treatment adherence in older patients with comorbid hypertension and type 2 diabetes mellitus.Participants and procedureItalian and Polish patients (≥ 65 years; N = 180) consecutively responded to self-report questionnaires measuring psycho-social (i.e., beliefs about medicines, perceived physician’s communication effectiveness, medication-specific social sup-port, self-efficacy) and behavioral factors (i.e., pharmacological adherence, medications refill adherence, intentional non-adherence) related to treatment adherence. Between-group comparisons and regression analyses were performed.ResultsFisher’s least significant difference (LSD) test showed significant differences between the Italian and Polish groups in all questionnaires (p < .01) with the Italian patients reporting more satisfactory scores. Younger age (β = .08, p = .045), female gender (β = 1.03, p = .042), higher medication refills adherence (β = –.07, p = .024), lower intentional non-adherence (β = –.03, p = .009), positive beliefs about medications (β = .13, p < .001), better quality of communication with the physician (β = .09, p < .001), and stronger perceived medication-specific social support (β = .06, p = .001) were significantly associat-ed with self-efficacy related to treatment adherence.ConclusionsFuture research and interventions should leverage psychosocial and behavioral factors to address self-efficacy contributing to enhancing adherence to clinical prescriptions.
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Granata N, Torlaschi V, Zanatta F, Giardini A, Maestri R, Pavesi C, Sommaruga M, Gazzi L, Bertolotti G, Sarzi Braga S, Monelli M, Zanelli E, Pierobon A. Positive affect as a predictor of non-pharmacological adherence in older Chronic Heart Failure (CHF) patients undergoing cardiac rehabilitation. PSYCHOL HEALTH MED 2023; 28:606-620. [PMID: 35603663 DOI: 10.1080/13548506.2022.2077394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In Chronic Heart Failure (CHF) patients, psychological and cognitive variables and their association with treatment adherence have been extensively reported in the literature, but few are the investigations in older people. The present study aimed to evaluate the psychological, cognitive, and adherence to treatment profile of older (>65 years) CHF patients, the interrelation between these variables, and identify possible independent predictors of self-reported treatment adherence. CHF inpatients undergoing cardiac rehabilitation were assessed for: anxiety, depression, cognitive impairment, positive and negative affect, and self-reported adherence (adherence antecedents, pharmacological adherence, and non-pharmacological adherence). 100 CHF inpatients (mean age: 74.9 ± 7.1 years) were recruited. 16% of patients showed anxiety and 24.5% depressive symptoms; 4% presented cognitive decline. Cognitive functioning negatively correlated to depression, anxiety, and negative affect (p < 0.01). The adherence antecedents (disease acceptance, adaptation, knowledge, and socio-familiar support) negatively correlated to anxiety (p < 0.05), depression (p < 0.001), and negative affect (p < 0.05), while they positively correlated to positive affect (p < 0.01). Pharmacological adherence negatively correlated to anxiety and negative affect (p < 0.05). Conversely, non-pharmacological adherence and positive affect positively correlated (p < 0.05). Furthermore, depression and anxiety negatively predicted adherence antecedents (β = -0.162, p = 0.037) and pharmacological adherence (β = -0.171, p = 0.036), respectively. Finally, positive affect was found as an independent predictor of non-pharmacological adherence (β = 0.133, p = 0.004). In cardiac rehabilitation, a specific psychological assessment focused on anxiety, depression, and affect can provide useful information to manage CHF older patients' care related to treatment adherence. In particular, positive affect should be targeted in future interventions to foster patients' non-pharmacological adherence.
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Affiliation(s)
- Nicolò Granata
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Valeria Torlaschi
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Claudia Pavesi
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
| | - Marinella Sommaruga
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Camaldoli, Milano, Italy
| | - Lidia Gazzi
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Lumezzane, Brescia, Italy
| | - Giorgio Bertolotti
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Tradate, Varese, Italy
| | - Simona Sarzi Braga
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Tradate, Varese, Italy
| | - Mauro Monelli
- Subacute Care, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Camaldoli, Milano, Italy
| | - Emanuela Zanelli
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCSS, Istituto di Lumezzane, Brescia, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCSS, Istituto Di Montescano, Pavia, Italy
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Kara S. General self-efficacy and hypertension treatment adherence in Algerian private clinical settings. J Public Health Afr 2022; 13:2121. [PMID: 36277949 PMCID: PMC9585610 DOI: 10.4081/jphia.2022.2121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/29/2022] [Indexed: 11/22/2022] Open
Abstract
Background The purpose of this study was to investigate the connection between self-efficacy and treatment adherence, working on the assumption that self-efficacy plays a role in determining treatment adherence in chronic diseases. Hypertension affects one-third of the world’s population. In Africa, hypertension is a leading cause of death from a non-communicable disease. Modifications to lifestyle and behavior, as well as increased access to pharmaceuticals, are necessary for every African nation to bring the prevalence of hypertension and cardiovascular disorders under control. Methods In order to assess the predictive association between the two, we conducted research on 216 hypertensive patients who were treated in private clinics in Algeria. These patients were given two assessments to fill out: one was called the general self-efficacy scale (GSES), and the other was called the treatment adherence scale. Comparisons of male and female self-efficacy and adherence were made with the help of Pearson’s correlation coefficient and a sample independent t-test (selfefficacy, adherence to treatment). Conclusions Self-efficacy in general has been shown to be connected with adherence to hypertension therapy (r(214) = 0.496, p=0.01, <0.05). There is no significant difference between the sexes in either selfefficacy (t(214)=0.985, p=0.326, >0.05) or hypertension treatment adherence (t(214)=0.034, p=0.973, >0.05). A higher level of self-efficacy was found to have a positive correlation with a higher level of treatment adherence; it is possible to increase the medication adherence of hypertension patients by enhancing their level of self-efficacy. It is important for those working in health care to acknowledge the significance that self-care plays in overall health.
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Świątoniowska-Lonc N, Polański J, Tański W, Jankowska-Polańska B. Impact of satisfaction with physician-patient communication on self-care and adherence in patients with hypertension: cross-sectional study. BMC Health Serv Res 2020; 20:1046. [PMID: 33198739 PMCID: PMC7670590 DOI: 10.1186/s12913-020-05912-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertension (HT) requires patients to continuously monitor their blood pressure, strictly adhere to therapeutic recommendations, and self-manage their illness. A few studies indicate that physician-patient communication and the patient's satisfaction with the therapeutic relationship may affect the course and outcomes of the treatment process. Research is still lacking on the association between satisfaction with physician-patient communication and adherence to treatment or self-care in chronically ill patients. The aim of the study was to evaluate the relationship between satisfaction with physician-patient communication and self-care and adherence in patients with HT undergoing chronic treatment. METHODS The following instruments were used: the Adherence to Refills and Medication Scale (ARMS) for evaluating adherence (12-48 points), the Self-Care of Hypertension Inventory (SCHI) for self-care level (0-100 points), and the Communication Assessment Tool (CAT) for evaluating satisfaction with physician-patient communication. Socio-demographic and clinical data were obtained from patients' medical records. The research has a cross-sectional and observational study design. Inclusion criteria were as follows: age > 18 years, hypertension diagnosed per European Society of Hypertension (ESH) guidelines, treatment with at least one antihypertensive drug for the past 6 months, and informed consent. Cognitively impaired patients unable to complete the surveys without assistance were excluded (MMSE ≤18). Correlations between quantitative variables were analyzed using Pearson's or Spearman's correlation coefficient. Linear regression was performed. Variable distribution normality was verified using the Shapiro-Wilk test. RESULTS The study included 250 patients (110 male, mean age 61.23 ± 14.34) with HT, treated at a hypertension clinic. In the CAT questionnaire individual questions pertaining to satisfaction with physician communication (on the CAT) were rated "excellent" 28.4-50.4% of the time. The best-rated aspects of communication included: letting the patient talk without interruptions (50.4% "excellent" ratings), speaking in a way the patient can understand (47.6%), and paying attention to the patient (47.2%). According to patient reports, physicians most commonly omitted such aspects as encouraging the patient to ask questions (28.4%), involving them in decisions (29.2%), and discussing the next steps (35.2%). The respondents had a low level of adherence to pharmaceutical treatment (16.63 ± 4.6). In terms of self-care, they scored highest in self-care management (64.17 ± 21.18), and lowest in self-care maintenance (56.73 ± 18.57). In correlation analysis, satisfaction with physician-patient communication (total CAT score) was positively correlated with all SCHI domains (self-care maintenance β = 0.276, self-care management β = 0.208, self-care confidence β = 0.286, p < 0.05), and negatively correlated with ARMS scores (indicating better adherence). CONCLUSIONS Satisfaction with physician-patient communication has a significant impact on self-care and pharmaceutical adherence in patients with hypertension. The more satisfied the patient is with communication, the better their adherence and self-care. TRIAL REGISTRATION SIMPLE: RID.Z501.19.016.
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Affiliation(s)
- Natalia Świątoniowska-Lonc
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, K. Bartla 5, 51-616, Wroclaw, Poland
| | - Jacek Polański
- Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Wojciech Tański
- Department of Internal Medicine, 4th Military Teaching Hospital, Wroclaw, Poland
| | - Beata Jankowska-Polańska
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, K. Bartla 5, 51-616, Wroclaw, Poland.
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