A literature review to explore the link between treatment satisfaction and adherence, compliance, and persistence

Figures & data

Figure 1 Steps and criteria for abstract and article selection.

Table 1 Studies examining links between satisfaction and adherence, compliance, or persistence

Author	Compliance/adherence/persistence measures	Satisfaction measures	Sample size, disease area	Treatments	Study objectives (as reported by authors)	Study design	Statistical tests: results (as reported by authors)
Brod et al^Citation14	Unvalidated self-reported questionnaire	ITSQ	N = 299, type 1 diabetes	Preprandial inhaled human insulin versus preprandial subcutaneous injections, both in combination with basal insulin	Validate ITSQ; examine relationships between treatment satisfaction and associated variables	Open-label RCT	Multivariate linear regression: greater medication compliance was associated with greater overall satisfaction (P < 0.01)
Gharabawi et al^Citation20	Number of days in study	Unvalidated self-report questionnaire	N = 381, schizophrenia	Three arms: risperidone, quetiapine, placebo	Examine predictors and consequences of patient satisfaction	Double-blind RCT	Graphic: patients who were satisfied clearly remained in the study significantly longer than those who were not satisfied (satisfied persons more than 40 days versus dissatisfied patients less than 30 days)
Jordan et al^Citation22	Unvalidated self-report questionnaire	HIV treatment satisfaction questionnaire	Trial 1: n = 211 Trial 2: n = 342 Trial 3: n = 195, HIV	Trial 1: two NRTIs + protease inhibitors versus two NRTIs + abacavir Trial 2: ZDV/3TC combined + abacavir versus ZDV/3TC combined + indinavir Trial 3 : ZDV/3TC + abacavir versus ZDV/3TC + nelfinavir	Analysis of the correlation between adherence and patient satisfaction	Three open-label RCTs	Multivariate logistic regression: patient satisfaction highly correlated with high adherence (odds ratio = 1.14 [1.04; 1.25], P = 0.006)
Testa and Simonson^Citation28	Barriers to insulin adherence questionnaire	Unvalidated self-report questionnaire	N = 120 adolescents, N = 207 adults, diabetes	Two arms: one randomized to insulin human inhalation powder and twice-daily neutral protamine Hagedorn insulin inhaled and one randomized to subcutaneous regimen	Compare impact of inhaled versus injected insulin on potential mediators of adherence	Noninferiority efficacy RCT	Spearman’s correlation: analyses between end point overall treatment satisfaction and insulin adherence barriers demonstrated greater satisfaction with lower barriers (r = −0.78, P < 0.0001)
Bonnick et al^Citation13	Unvalidated self-report questionnaire	Osteoporosis patient satisfaction questionnaire	N = 1678, osteoporosis	150 g monthly ibandronate versus previous weekly treatment	Assess patient satisfaction levels and patient treatment preference after switching from weekly oral bisphosphonate to monthly oral bisphosphonate	Nonrandomized clinical trial, longitudinal	Multivariate logistic regression: patients who reported missing three or more doses with prestudy weekly treatment were two times more likely to be satisfied with monthly treatment than patients who did not (81.9% versus 69.4%; odds ratio = 1.82 [1.13; 3.04], P = 0.017)
Bharmal et al^Citation9	Modified Morisky scale	TSQM-9	N = 396, hypertension	An antihypertensive medication	Psychometrically validate TSQM-9	Observational longitudinal	Spearman’s correlation: adherence positively correlated with convenience (0.46), effectiveness (0.38), and global satisfaction (0.34). Analysis of covariance: higher satisfaction among medium compliers compared to low compliers (adjusted mean scores respectively, 77.1 versus 66.1 for effectiveness, 84.0 versus 71.7 for convenience and 79.3 versus 68.4 for global satisfaction with all P < 0.0001)
Biderman et al^Citation10	Unvalidated self-report questionnaire	Diabetes treatment satisfaction questionnaire	N = 630, type 2 diabetes	Diet, oral hypoglycemic agent, insulin or both	Determine relationship between treatment satisfaction and sociodemographic, clinical, adherence, treatment, and health perception factors	Observational cross-sectional	Analysis of variance: satisfaction was lower in patients with difficulties in adherence than patients with no difficulties for three questionnaire items of four (P = 0.054, 0.027, <0.001, <0.001). Multivariate linear regression: difficulties in adherence were independently associated with lower treatment satisfaction (P < 0.001 for two items of four)
Blalock and Patel^Citation11	Unvalidated self-report questionnaire	Scale to assess patients’ perceptions of drug therapy problems	N = 200, no specific disease area	Prescription medication (various)	Development of drug therapy problems questionnaire	Observational cross-sectional	Pearson’s correlation: overall satisfaction was positively correlated with adherence (r = 0.46, P < 0.0001). Multivariate linear regression: adherence issues were independently associated with treatment satisfaction but explain only 2% of the variance of the model
Bolge et al^Citation12	Morisky medication adherence scale	Unvalidated self-report questionnaire	N = 345, overactive bladder	Patients with extended-release tolterodine or oxybutynin but no other prescription product for overactive bladder	Evaluate the effects of individual and condition characteristics on satisfaction with extended-release tolterodine or oxybutynin in overactive bladder	Observational cross-sectional	Chi-square: satisfied respondents were more likely to use their medication closer to every day and reported more adherent attitudes than those less satisfied (P < 0.001 for both). Multivariate linear regression: longer duration of use and more frequent medication use were apparent predictors of medication satisfaction but were not statistically significant (P = 0.052 and 0.096, respectively)
Cady et al^Citation15	Refill or prescription data	Unvalidated self-report questionnaire	N = 785, migraine	Triptans	Identify factors that predict adherence to triptans by migraine patients	Observational cross-sectional	Multivariate analysis of variance: patients who sustained use of triptans had a significantly higher level of satisfaction than lapsed users with nontriptan medication (no statistical results shown). Multivariate linear regression: adherence was not identified as a predictor of satisfaction (no statistical results shown)
Carr et al^Citation16	Unvalidated self-report questionnaire	Unvalidated self-report questionnaire	N = 533, osteoporosis	Bisphosphonates	Determine the factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis	Observational cross-sectional	Chi-square: dissatisfaction with treatment was associated with nonadherence and nonpersistence (P = 0.05 and P < 0.001, respectively). Multivariate logistic regression: adherence was significantly associated with less dissatisfaction with treatment (odds ratio = 1.65 [0.44;0.97], P = 0.04). Cox proportional hazard model: nonpersistence was significantly associated with dissatisfaction with treatment (hazard ratio = 1.83 [1.38;2.43], P = 0.0001)
Day et al^Citation17	Clinician judgment	TSS-IOP	N = 250, glaucoma and ocular hypertension	Currently treated with marketed glaucoma ophthalmic drop medication in at least one eye	Psychometrically validate the TSS-IOP	Observational one part cross-sectional and one part longitudinal	Spearman’s correlation: patients’ reluctance to use medications negatively correlated with perceived effectiveness (r = −0.29, P < 0.001), convenience of use (r = −0.24, P < 0.001), and ease of use (r = −0.15, P < 0.05). Physician ratings of patient compliance were not significantly related to any dimension of patient satisfaction (P < 0.05)
Dreno et al^Citation18	Elaboration d’un outil d’évaluation de l’observance des traitements médicamenteux (Development of an evaluation tool for treatment compliance) [French]	Unvalidated self-report questionnaire	N = 3339, acne	Topical and/or systemic therapy	Evaluate the risk of poor adherence with acne therapies and identify major factors influencing adherence in patients treated with topical and/or systemic agents	Observational cross-sectional	Polytomous regression: patient’s dissatisfaction was correlated with poor adherence (odds ratio = 2.69)
Gasquet et al^Citation19	Unvalidated self-report questionnaire and clinician judgment	Unvalidated self-report questionnaire	N = 933, schizophrenia	Two cohorts: patients who initiated therapy with or changed to olanzapine and patients who initiated therapy with or changed to a nonolanzapine antipsychotic	Analyze relationships between patient satisfaction, clinical status, quality of life, compliance, and the type of antipsychotic treatment. Assess elements of validity of an overall evaluation of patient satisfaction with psychotropics	Observational longitudinal	Chi-square: statistically significant relationship between persistence and change in patient satisfaction (P = 0.001): higher treatment continuation among patients with higher satisfaction. Structural equation model: direct significant relationship was observed on compliance (coefficient = 0.16) with higher satisfaction leading to higher compliance
Gray et al^Citation21	Clinician judgment	SWAM	N = 44, prisoners taking antipsychotic medication	Antipsychotic medication	Explore relationships between medication adherence and demographic, prison, social, and clinical factors in prisoners taking antipsychotic medication	Observational cross-sectional	Pearson’s correlation: adherence positively correlated with SWAM “treatment acceptability” dimension. Multivariate linear regression: SWAM “treatment acceptability” dimension had an impact on adherence (estimate = 0.70, P < 0.001)
Miasso et al^Citation23	Morisky–Green Test	Semi-structured interview	N = 21, bipolar affective disorder	Any treatment for bipolar affective disorder	To verify the adherence of people with bipolar affective disorder to medication and compare, among adherent and nonadherent patients, satisfaction with the health team and treatment	Cross-sectional, observational, qualitative, and quantitative study in Brazil. Semi-structured interviews used for data collection	Descriptive statistics: of six patients who adhered, three (50%) were satisfied, one (16.7%) had doubts about its efficacy and two (33.3%) patients were dissatisfied
Regnault et al^Citation24	EDSQ and electronic system	EDSQ	N = 180, glaucoma	Glaucoma treatment	Ascertain the scoring and assess the psychometric properties of the EDSQ	Observational cross-sectional	Kruskal–Wallis: no association found between the six EDSQ dimension scores and compliance profiles (low, moderate, high): P > 0.079 for all
Rofail et al^Citation25	Satisfaction with ICT	Satisfaction with ICT	N = 107, thalassemia sickle cell disease or myelodysplastic syndromes	Lifelong ICT, oral chelator deferasirox	To describe the development scoring and validity of the satisfaction with ICT instrument. To assess satisfaction with ICT. To explore relationship between satisfaction and adherence to ICT	Observational cross-sectional	Multivariate linear regression: satisfaction domains (perceived effectiveness, burden, and side-effects) were predictors of “never thinking about stopping” (coefficient = 0.44, 0.42, and 0.27; P = 0.003, 0.002, and 0.01, respectively)
Ruiz et al^Citation26	Morisky–Green Test and clinician judgment	Glaucoma satisfaction questionnaire	N = 98, glaucoma	Glaucoma treatment	Report on development and initial psychometric properties of glaucoma satisfaction questionnaire	Observational cross-sectional	Spearman’s correlation: compliance was correlated with patient’s self-reported effectiveness (r = 0.403, P = 0.003) and tolerability (r = 0.456, P = 0.001)
Shigemura et al^Citation27	Unvalidated self-report questionnaire	Unvalidated self-report questionnaire	N = 1151, depressive disorder	Various antidepressant treatments (patients already taking them): amitriptyline, amoxapine, clomipramine, fluvoxamine, imipramine, maprotiline, milnacipran, nortriptyline, paroxetine, sulpiride, trazodone, others.	Ascertain the relationships between antidepressant adherence, sociodemographic factors, pharmacological characteristics, and subjective perceptions	Observational cross-sectional	Student’s t-test: low adherence was associated with low drug satisfaction (P = 0.001). Pearson’s correlation: satisfaction score negatively correlated with nonadherence (r = −0.115, P < 0.001)

Abbreviations: 3TC, lamivudine; EDSQ, Eye-Drop Satisfaction Questionnaire; HIV, human immunodeficiency virus; ICT, iron chelation therapy; ITSQ, Insulin Treatment Satisfaction Questionnaire; NRTI, nucleoside reverse transcriptase inhibitor; RCT, randomized controlled trial; SWAM, Satisfaction with Antipsychotic Medication; TSQM-9, Treatment Satisfaction Questionnaire for Medication-9; TSS-IOP, Treatment Satisfaction Survey-Intraocular Pressure; ZDV, zidovudine.

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GharabawiGMGreenspanARupnowMFReduction in psychotic symptoms as a predictor of patient satisfaction with antipsychotic medication in schizophrenia: data from a randomized double-blind trialBMC Psychiatry200664517054789

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JordanJCahnPGoebelFMatheronSBradleyCWoodcockAAbacavir compared to protease inhibitors as part of HAART regimens for treatment of HIV infection: patient satisfaction and implications for adherenceAIDS Patient Care STDS200519191815665631

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