Medication adherence and beliefs about medication in elderly patients living alone with chronic diseases

Figures & data

Figure 1 Relationship between beliefs about medication and medication adherence.

Figure 2 Framework of patients’ attitudes and beliefs about medication.

Table 1 Baseline characteristics of participants (N=3,326)

	N (%)
Gender
Male	543 (16.3)
Female	2,783 (83.7)
Age group
65–74	904 (27.2)
75–84	1,836 (55.2)
≥85	586 (17.6)
Marital status
Never married	143 (4.4)
Widowed	2,621 (79.7)
Divorced	405 (12.3)
Separated	119 (3.6)
Education
Uneducated	1,405 (42.7)
Elementary school	1,089 (33.1)
Middle school	400 (12.1)
High school or more	400 (12.1)
Religion
Yes	2,127 (64.1)
Number of medication
1–4	1,342 (40.3)
5–9	1,160 (34.9)
≥10	824 (24.8)
Income (per month), Korean Won
<300,000	390 (11.7)
300,000–599,999	2,286 (68.7)
600,000–899,999	446 (13.4)
≥900,000	204 (6.2)
Health insurance
National Health Insurance	1,727 (52.2)
Medical Aid	1,583 (47.8)
Type of diseasesa
Hypertension	2,496 (75.1)
Diabetes mellitus	977 (29.4)
Arthritis	1,080 (32.5)
Osteoporosis	437 (13.1)
Number of chronic diseases
1	755 (23.4)
2	1,141 (35.4)
3	810 (25.2)
≥4	514 (16.0)

Notes:

a Multiple answers were allowed.

Table 2 Distribution of ARMS

Items	Mean ± SDa	None of the time (%)	Sometimes, often or all of the time (%)
Medication taking
1. Forget to take your medicine?	1.39±0.56	64.3	35.7
2. Decide not to take your medicine?	1.12±0.39	90.6	9.4
5. Skip a dose of your medicine before you go to the doctor?	1.13±0.40	88.3	11.7
6. Miss taking your medicine when you feel better?	1.16±0.46	87.0	13.0
7. Miss taking your medicine when you feel sick?	1.11±0.37	91.1	8.9
8. Miss taking your medicine when you are careless?	1.32±0.53	70.6	29.4
9. Change the dose of your medicines to suit your needs (like when you take more of less pills than you’re supposed to)?	1.09±0.35	93.0	7.0
10. Forget to take your medicine when you are supposed to take it more than once a day?	1.23±0.51	80.5	19.5
Prescription refill
3. Forget to get prescriptions filled?	1.08±0.31	92.7	7.3
4. Run out of medicine?	1.08±0.32	92.6	7.4
11. Put off refilling your medicines because they cost too much money?	1.06±0.32	95.4	4.6
12. Plan ahead and refill your medicines before they run out?b	3.32±1.10	65.6	34.4

Notes:

a Possible range, 1–4.

b This item was reverse coded. The included ARMS subscales are reproduced with permission from Kripalani S, Risser J, Gatti ME, Jacobson TA. Development and evaluation of the adherence to refills and medications scale (ARMS) among low-literacy patients with chronic disease. Value Health. 2009;12(1):118–123. Copyright © 2009 Emory University.¹⁷

Abbreviations: ARMS, Adherence to Refills and Medication Scale; SD, standard deviation.

Table 3 The difference of medication adherence between attitudinal groupsa

Attitudes toward medicationsb	Mean ARMSc score (SD)	p-value
Accepting	15.66 (2.23)	<0.001
Indifferent	16.36 (3.72)
Skeptical	17.32 (3.70)
Ambivalent	16.30 (2.96)
Accepting vs indifferent		<0.001
Accepting vs skeptical		<0.001
Accepting vs ambivalent		<0.001
Indifferent vs skeptical		0.084
Indifferent vs ambivalent		0.969
Skeptical vs ambivalent		0.031

Notes:

a Using one-way analysis of variance and post hoc test.

b Using Belief about Medicines Questionnaire scores with the level of necessity and concerns.

c Adherence to Refills and Medication Scale.

Abbreviations: ARMS, Adherence to Refills and Medication Scale; SD, standard deviation.

Table 4 Multivariable analysis with medication adherence

Variables	Multivariable β coefficient	p-value	95% confidence interval
Attitudes toward medicationsa
Accepting	Reference
Indifferent	0.487	0.003	0.17, 0.81
Skeptical	1.161	0.001	0.47, 1.85
Ambivalent	0.371	<0.001	0.17, 0.58
Burden of drug costs	0.109	0.006	0.03, 0.19
Medication side effects
No	Reference
Yes	0.431	0.008	0.11, 0.75
Medication satisfaction	−0.626	<0.001	−0.77, −0.48
Subjective health status	−0.151	0.015	−0.27, −0.03
Health insurance
National health insurance	Reference
Medical aid	0.655	<0.001	0.42, 0.89

Note:

a Using Belief about Medicines Questionnaire scores with the level of necessity and concerns.

KripalaniSRisserJGattiMEJacobsonTADevelopment and evaluation of the adherence to refills and medications scale (ARMS) among low-literacy patients with chronic diseaseValue Health200912111812319911444

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