Exploring Medicines Burden Among Adults in New Zealand: A Cross-Sectional Survey

Figures & data

Table 1 Participant Characteristics and Mean LMQ Scores

	Online Survey	Community Pharmacy Survey	p-value^a	All Participants	Mean LMQ Scores Score (SD)
	n (%)	n (%)		n (%)
Participants
All	327	145		472	101.8 (21.0)
Male	125 (38.2%)	52 (35.9%)	0.625	177 (37.5%)	102.1 (19.2)
Female	202 (61.8%)	93 (64.1%)	0.625	295 (62.5%)	101.7 (22.0)
p-value within group^b					0.857
Age group
18–29	34 (10.4%)	13 (9.0%)	0.616	47 (10.0%)	111.1 (24.4)
30–49	49 (15%)	22 (15.2%)	0.981	71 (15.0%)	103.0 (26.4)
50–64	80 (24.5%)	38 (26.2%)	0.687	118 (25.0%)	102.0 (19.3)
≥65	164 (50.2%)	72 (49.7%)	0.921	236 (50.0%)	99.6 (18.6)
p-value within group^c					0.007
Ethnicity
European	293 (89.6%)	129 (89.0%)	0.836	422 (89.4%)	101.4 (20.9)
Māori	15 (4.6%)	7 (4.8%)	0.909	22 (4.7%)	107.9 (16.8)
Pacific Peoples	2 (0.6%)	3 (2.1%)	0.154	5 (1.1%)	100.2 (19.0)
Asian	4 (1.2%)	2 (1.4%)	0.889	6 (1.3%)	108.8 20.8
Other Ethnicity	13 (4.0%)	4 (2.8%)	0.513	17 (3.6%)	103.8 (27.2)
p-value within group^c					0.572
Employment
Employed	133 (40.7%)	49 (33.8%)	0.157	182 (38.6%)	101.0 (19.3)
Unemployed	19 (5.8%)	17 (11.7%)	0.026	36 (7.6%)	114.9 (27.9)
Retired	159 (48.6%)	73 (50.3%)	0.730	232 (49.2%)	99.7 (19.2)
Full-Time Student	16 (4.9%)	6 (4.1%)	0.720	22 (4.7%)	110.0 (29.3)
p-value within group^c					<0.001
Education (highest level)
School	70 (21.4%)	35 (24.1%)	0.510	105 (22.2%)	104.4 (22.1)
Technical college/apprenticeship	78 (28.4%)	42 (29.0%)	0.239	120 (25.4%)	104.7 (19.6)
University	145 (44.3%)	58 (40.0%)	0.379	203 (43.0%)	98.4 (21.0)
Other	34 (10.4%)	10 (6.9%)	0.227	44 (9.3%)	103.8 (20.2)
p-value within group^c					0.023
Number of medicines used
1 to 4	135 (41.3%)	73 (50.3%)	0.068	208 (44.1%)	97.9 (19.4)
5 to 9	150 (45.9%)	57 (39.3%)	0.185	207 (43.8%)	104.4 (21.0)
≥ 10	42 (12.8%)	15 (10.3%)	0.442	57 (12.1%)	107.0 (24.1)
p-value within group^c					0.001
Frequency of medicine use
Once daily	104 (31.8%)	62 (42.8%)	0.021	166 (35.2%)	95.8 (19.8)
Twice daily	140 (42.8%)	50 (34.5%)	0.080	190 (40.3%)	102.5 (19.6)
Three times daily	35 (10.7%)	16 (11.0%)	0.915	51 (10.8%)	109.3 (22.5)
≥4 times daily	48 (14.7%)	17 (11.7%)	0.390	65 (13.8%)	109.5 (22.3)
p-value within group^c					< 0.001
Requires help with medicine use
Independent	315 (96.3%)	134 (92.4%)	0.068	449 (95.1%)	101.1 (20.2)
Receives help	12 (3.7%)	11 (7.6%)	0.068	23 (4.9%)	116.0 (29.2)
p-value within group^b					0.001
Pays for prescriptions
Yes	295 (90.2%)	134 (92.4%)	0.444	429 (90.9%)	102.2 (21.3)
No	32 (9.8%)	11 (7.6%)	0.444	43 (9.1%)	98.5 (17.6)
p-value within group^a					0.269

Notes: ^aChi-squared test; ^bt-test within group; ^cAnalysis of variance (ANOVA).

Table 2 Domain Analysis. Responses to Statements

Statements	Agree/Strongly Agree, N (%)	Strongly Disagree/Disagree, N (%)	Neutral, N (%)
1: Relationships (Items=5, α=0.820; Mean (SD)=11.2 (3.5); % maximum score=44.8%)
I trust the judgement of my doctor(s) in choosing medicines for me	370 (78.4%)	47 (10.0%)	55 (11.7%)
My doctor(s) listen to my opinions about my medicines	330 (69.9%)	37 (7.8%)	105 (22.5%)
My doctor takes my concerns about side effects seriously	322 (68.2%)	43 (9.1%)	107 (22.7%)
I get enough information about my medicines from my doctor(s)	267 (56.6%)	92 (19.5%)	113 (23.9%)
The health care professionals providing my care know enough about me and my medicines	357 (75.6%)	49 (10.4%)	66 (14.0%)
2: Practicalities (Items=7, α=0.811; Mean (SD)=15.2 (4.4); % maximum score=43.4%)
I find getting my prescriptions from the doctor difficult.	53 (11.2%)	377 (79.9%)	42 (8.9%)
I find getting my medicines from the pharmacist difficult.	30 (6.4%)	403 (85.4%)	39 (8.3%)
I am comfortable with the times I should take my medicines.	386 (81.8%)	54 (11.4%)	32 (6.8%)
I am concerned that I may forget to take my medicines.	147 (31.1%)	253 (53.6%)	72 (15.3%)
I have to put a lot of planning and thought into taking my medicines.	128 (27.1%)	260 (55.1%)	84 (17.8%)
It is easy to keep to my medicines routine.	360 (76.3%)	56 (11.9%)	56 (11.9%)
I find using my medicines difficult.	30 (6.4%)	391 (82.8%)	51 (10.8%)
3: Cost (Items=3, α=0.823; Mean (SD)=6.9 (3.0); % maximum score=46.0%)
I worry about paying for my medicines.	136 (28.8%)	243 (51.5%)	93 (19.7%)
I sometimes have to choose between buying basic essentials or medicines.	53 (11.2%)	380 (80.5%)	39 (8.3%)
I have to pay more than I can afford for my medicines.	72 (15.3%)	307 (65.0%)	93 (19.7%)
4: Side effects (Items=4, α=0.807; Mean (SD)=10.4 (4.0); % maximum score=52.0%)
The side effects I get are sometimes worse than the problem for which I take medicines.	125 (26.5%)	243 (51.5%)	104 (22.0%)
The side effects I get from my medicines interfere with my day-to-day life (eg, work, housework, sleep).	132 (28.0%)	260 (55.1%)	80 (16.9%)
The side effects I get from my medicines are bothersome.	138 (29.2%)	256 (54.2%)	78 (16.5%)
The side effects I get from my medicines adversely affect my well-being.	83 (17.6%)	279 (59.1%)	110 (23.3%)
5: Lack of effect (Items=6, α=0.825; Mean (SD)=13.3 (3.9); % maximum score=44.3%)
I am satisfied with the effectiveness of my medicines.	335 (71.0%)	62 (13.1%)	75 (15.9%)
My medicines prevent my condition getting worse.	387 (82.0%)	35 (7.4%)	50 (10.6%)
My medicines live up to my expectations.	300 (63.6%)	45 (9.5%)	127 (26.9%)
My medicines allow me to live my life as I want to.	332 (70.3%)	52 (11.0%)	88 (18.6%)
My medicines are working.	378 (80.1%)	20 (4.2%)	74 (15.7%)
The side effects are worth it for the benefits I get from my medicines.	257 (54.4%)	37 (7.8%)	178 (37.7%)
6: Concerns (Items=7, α=0.804; Mean (SD)=20.2 (5.1); % maximum score=57.7%)
I worry that I have to take several medicines at the same time.	99 (21.0%)	270 (57.2%)	103 (21.8%)
I would like more say in the brands of medicines I use.	127 (26.9%)	139 (29.4%)	206 (43.6%)
I feel I need more information about my medicines.	160 (33.9%)	208 (44.1%)	104 (22.0%)
I am concerned about possible damaging long-term effects of taking medicines.	283 (60.0%)	109 (23.1%)	80 (16.9%)
I am concerned that I am too reliant on my medicines.	157 (33.3%)	196 (41.5%)	119 (25.2%)
I am concerned that my medicines interact with alcohol.	75 (15.9%)	235 (49.8%)	162 (34.3%)
I worry that my medicines may interact with each other.	147 (31.1%)	201 (42.6%)	124 (26.3%)
7: Interference (Items=6, α=0.803; Mean (SD)=13.9 (4.9); % maximum score=46.3%)
My medicines interfere with my social or leisure activities.	90 (19.1%)	314 (66.5%)	68 (14.4%)
Taking medicines affects my driving.	41 (8.7%)	366 (77.5%)	65 (13.8%)
My medicines interfere with my social relationships.	60 (12.7%)	334 (70.8%)	78 (16.5%)
Taking medicines causes me problems with daily tasks (such as work, housework, hobbies).	66 (14.0%)	347 (73.5%)	59 (12.5%)
My medicines interfere with my sexual life.	106 (22.5%)	252 (53.4%)	114 (24.2%)
My life revolves around using my medicines.	135 (28.6%)	257 (54.4%)	80 (16.9%)
8: Autonomy. (Items=3, α=0.858; Mean (SD)=10.7 (2.7); % maximum score=71.3%)
I can vary the dose of the medicines I take.	109 (23.1%)	318 (67.4%)	45 (9.5%)
I can choose whether or not to take my medicines.	110 (23.3%)	315 (66.7%)	47 (10.0%)
I can vary the times I take my medicines.	137 (29.0%)	256 (54.2%)	79 (16.7%)

Notes: Full domain names: 1: Relationships/communication with health professionals about medicines, 2: Practicalities, 3: Cost-related burden, 4: Side effect burden, 5: Lack of effectiveness, 6: Attitudes and concerns about medicines, 7: Impact and interference on day-to-day life 8: Control and autonomy to vary routine.

Table 3 Mean Domain Scores by Participant Characteristics

Characteristics p-value Within Group	1: Relationships (Max Score=25) Mean (SD)	2: Practicalities (Max Score=35) Mean (SD)	3: Cost (Max Score=15) Mean (SD)	4: Side Effect (Max Score=20) Mean (SD)	5: Lack of Effect (Max Score=30) Mean (SD)	6: Concerns (Max Score=35) Mean (SD)	7: Interference (Max Score=30) Mean (SD)	8: Autonomy (Max Score=15) Mean (SD)
Gender
Male (n=177)	11.1 (3.0)	15.0 (4.2)	6.5 (2.8)	10.4 (3.7)	13.2 (3.4)	20.4 (4.8)	14.4 (4.6)	11.1 (2.3)
Female (n=295)	11.2 (3.8)	15.2 (4.6)	7.2 (3.1)	10.5 (4.1)	13.3 (4.1)	20.2 (5.4)	13.7 (5.1)	10.4 (2.9)
p-value^a	0.771	0.581	0.011	0.912	0.760	0.620	0.150	0.011
Age group (years)
18–29 (n=47)	11.8 (3.6)	18.5 (4.8)	8.7 (3.2)	11.0 (4.5)	12.5 (3.9)	22.1 (6.0)	17.1 (6.3)	9.4 (3.2)
30–49 (n=71)	11.5 (4.1)	15.9 (5.6)	6.8 (3.2)	10.6 (4.1)	13.1 (4.7)	20.7 (5.6)	14.4 (5.6)	9.8 (2.7)
49–64 (n=118)	11.1 (3.4)	15.2 (4.1)	6.8 (3.2)	10.4 (3.9)	13.5 (3.4)	20.9 (4.8)	13.5 (4.4)	10.5 (2.8)
≥65 (n=236)	11.0 (3.3)	14.3 (3.7)	6.6 (2.7)	10.3 (3.9)	13.4 (3.8)	19.4 (4.8)	13.4 (4.3)	11.3 (2.4)
p-value^b	0.353	<0.001	<0.001	0.693	0.502	0.001	<0.001	<0.001
Ethnicity
European (n=422)	11.1 (3.5)	15.0 (4.4)	6.8 (3.0)	10.4 (4.0)	13.2 (3.8)	20.0 (5.1)	13.9 (4.9)	10.8 (2.7)
Māori (n=22)	10.8 (2.8)	17.2 (4.8)	8.3(3.3)	11.2 (3.6)	13.2 (3.7)	22.6 (4.2)	14.6 (4.7)	10.0 (3.0)
Pacific Peoples (n=5)	10.8 (3.3)	18.4 (4.0)	6.6 (1.1)	8.2 (1.6)	14.6 (2.8)	21.2 (4.5)	12.0 (3.9)	8.4 (2.8)
Asian (n=6)	12.0 (3.2)	15.3 (3.8)	6.2 (1.5)	11.5 (4.5)	14.5 -(1.8)	22.3 (5.6)	17.7 (5.8)	9.2 (1.9)
Other (n=17)	12.4 (4.4)	15.1 (4.9)	7.3 (3.7)	9.9 (4.4)	13.4 (5.9)	21.0 (5.8)	13.7 (5.4)	11.0 (2.1)
p-value^b	0.6129	0.096	0.266	0.537	0.877	0.152	0.309	0.118
Employment
Employed (n=182)	11.1 (3.4)	15.7 (4.2)	6.8 (3.0)	10.3 (3.9)	13.1 (3.7)	20.5 (4.8)	13.6 (4.7)	10.0 (2.8)
Unemployed (n=36)	12.3 (4.7)	17.6 (6.1)	8.8 (3.6)	12.5 (4.5)	14.1 (4.6)	22.4 (5.3)	17.0 (6.6)	10.3 (2.8)
Retired (n=232)	10.9 (3.3)	17.6 (6.1)	6.6 (2.8)	10.2 (3.8)	13.4 (3.8)	19.5 (5.0)	13.5 (4.4)	11.4 (2.4)
Full Time Student (n=22)	12.1 (3.9)	17.5 (5.9)	8.4 (3.5)	10.9 (4.9)	12.6 (4.5)	22.3 (7.0)	16.1 (6.7)	10.1 (3.7)
p-value^b	0.084	<0.001	<0.001	<0.01	0.416	0.002	<0.001	<0.001
Education
School (n=105)	11.4 (3.9)	14.7 (4.8)	7.6 (2.9)	10.7 (3.9)	13.6 (4.1)	20.7 (5.2)	14.4 (4.6)	11.3 (2.4)
Tech (n=120)	11.3 (3.6)	15.2 (4.0)	7.5 (3.0)	10.7 (3.9)	13.7 (4.1)	20.8 (4.8)	14.7 (4.7)	10.6 (2.5)
University (n=203)	10.9 (3.2)	15.4 (4.6)	6.3 (3.0)	10.0 (4.1)	12.9 (3.5)	19.5 (5.3)	13.1 (5.0)	10.3 (2.9)
Other (n=44)	11.4 (3.7)	15.0 (3.8)	6.8 (2.7)	10.9 (3.8)	13.4 (4.6)	20.8 (5.0)	14.3 (5.2)	11.3 (2.9)
p-value^b	0.651	0.605	<0.001	0.223	0.277	0.059	0.021	0.013
Number of medicines
1–4 (n=208)	11.1 (3.4)	15.1 (4.4)	6.3 (2.7)	9.6 (3.6)	13.1 (3.8	19.4 (5.0)	12.8 (4.60	10.4 2.7
5–9 (n=207)	11.3 (3.5)	15.0 (4.4)	7.2 (3.0)	11.0 (4.0)	13.4 (3.8)	20.9 (5.1)	14.6 (5.0)	10.9 (2.7)
≥10 (n=57)	10.6 (4.0)	15.9 (4.7)	8.2 (3.4)	11.5 (4.4)	13.4 (4.3)	21.1 (5.5)	15.4 (4.5)	10.9 (2.7)
p-value^b	0.422	0.438	<0.001	<0.001	0.731	0.006	<0.001	0.171
Frequency of medicine use
Once daily (n=166)	10.9 (3.2)	14.2 (3.9)	6.2 (2.8)	9.3 (3.6)	13.1 (3.7)	19.0 (5.1)	12.3 (4.4)	10.7 (2.5)
Twice daily (n=190)	11.1 (3.6)	14.8 (4.2)	6.8 (2.8)	10.6 (3.9)	13.2 (3.9)	20.9 (4.9)	13.8 (4.4)	11.2 (2.6)
Three times daily (n=51)	11.1 (4.0)	16.9 (4.7)	7.8 (3.4)	12.1 (4.4)	13.8 (4.0)	21.3 (5.0)	15.5 (5.7)	10.7 (2.5)
≥4 times daily (n=65)	11.8 (3.7)	17.3 (5.1)	8.3 (3.4)	11.5 (4.1)	13.5 (4.3)	20.7 (5.7)	17.3 (5.0)	9.0 (3.0)
p-value^b	0.421	<0.001	<0.001	<0.001	0.638	0.001	<0.001	<0.001
Requires help with medicines use
Yes (n=23)	11.7 (4.2)	18.3 (6.3)	9.0 (2.8)	12.3 (4.6)	14.1 (4.5)	22.3 (6.1)	17.5 (6.2)	10.8 (2.6)
No (n=449)	11.1 (3.5)	15.0 (4.3)	6.8 (3.0)	10.3 (3.9)	13.2 (3.9)	20.1 (5.1)	13.7 (4.8)	10.7 (2.7)
p-value^a	0.450	<0.001	0.001	0.018	0.282	0.054	<0.001	0.871
Pays for prescriptions
Yes (n=429)	11.2 (3.5)	15.2 (4.5)	7.1 (3.0)	10.4 (4.0)	13.3 (4.0)	20.3 (5.2)	14.0 (5.0)	10.6 (2.8)
No (n=43)	10.5 (3.2)	14.7 (3.9)	6.9 (3.0)	10.5 (3.9)	12.7 (2.8)	19.8 (5.0)	13.6 (3.5)	11.2 (2.4)
p-value^a	0.190	0.417	0.003	0.964	0.304	0.525	0.626	0.193
Recruitment site
Internet (n=327)	11.6 (3.6)	15.5 (4.5)	6.8 (2.9)	10.8 (3.9)	13.4 (4.0)	20.8 (5.0)	14.2 (4.9)	10.9 (2.7)
Community pharmacy (n=145)	10.1 (3.1)	14.6 (4.1)	7.1 (3.2)	9.6 (4.1)	13.1 (3.6)	19.0 (5.3)	13.3 (4.9)	10.3 (2.7)
p-value^a	<0.001	0.044	0.331	0.003	0.581	<0.001	0.056	0.024

Notes: ^aIndependent t-test; ^bAnalysis of variance (ANOVA). Full domain names: 1: Relationships/communication with health professionals about medicines, 2: Practicalities, 3: Cost-related burden, 4: Side effect burden, 5: Lack of effectiveness, 6: Attitudes and concerns about medicines, 7: Impact and interference on day-to-day life, 8: Control and autonomy to vary routine.

Abbreviation: Tech, technical college/apprenticeship.

Table 4 Multiple Linear Regression – LMQ-3 Score versus Participants’ Sociodemographic and Medicine-Use Characteristics

Independent Variables (Reference)	B	Std. Err.	Beta	t	P-value|	95% Confidence. Intervals		F	Prob > F	R-Squared	Adj R-Squared
Age (18–29 years)	10.73	3.13	0.153	3.43	0.001	4.59	16.87	F(5,466) 13.37	0.001	0.125	0.116
Employment (Unemployed)	12.40	3.43	0.157	3.62	<0.001	5.66	19.15
Education (University)	−5.66	1.86	−0.134	−3.04	0.003	−9.32	−2.00
Number of medicines (≥5)	6.14	1.89	0.146	3.25	0.001	2.43	9.85
Frequency of medicines (≥ 3 times daily)	7.39	2.17	0.152	3.40	0.001	3.12	11.66
Constant	97.01	1.73	.	55.92	<0.001	93.60	100.41

Abbreviations: B, unstandardized coefficient; Beta, standardized coefficient.

Table 5 Multiple Linear Regression – Domain Scores versus Participants’ Sociodemographic and Medicine-Use Characteristics

	B Coefficient	Standard Error	Beta Coefficient	t	P-value	95% Confidence Intervals		F	Prob > F	R-Squared	Adj R-Squared
1. Relationships
Unemployed	1.27	0.61	0.10	2.10	0.036	0.08	2.46	F(1,470) 4.42	0.036	0.009	0.007
Constant	11.06	0.17	.	66.14	<0.001	10.73	11.39
2. Practicalities
18–29 years-old	3.04	0.64	0.21	4.75	<0.001	1.78	4.30	F(5,466)15.98	<0.001	0.146	0.137
European	−1.40	0.62	−0.10	−2.28	0.023	−2.61	−0.19
Unemployed	1.79	0.74	0.11	2.41	0.016	0.33	3.24
Uses medicines ≥3x daily	2.10	0.45	0.20	4.72	<0.001	1.23	2.98
Requires assistance with medicines use	2.23	0.92	0.11	2.44	0.015	0.43	4.03
Constant	15.36	0.60	.	25.77	<0.001	14.19	16.53
3. Cost
Unemployed	1.40	0.50	0.12	2.79	0.006	0.41	2.39	F(6,465)14.86	<0.001	0.161	0.150
University educated	−1.02	0.26	−0.17	−3.91	<0.001	−1.53	−0.51
Uses ≥ 5 medicines	0.82	0.26	0.14	3.12	0.002	0.30	1.34
Uses medicines ≥ 3x daily	1.34	0.30	0.19	4.44	<0.001	0.75	1.94
Requires assistance with medicines use	1.45	0.62	0.10	2.34	0.020	0.23	2.67
Pays for prescription medicines	1.63	0.45	0.16	3.65	<0.001	0.75	2.51
Constant	4.91	0.48	.	10.23	<0.001	3.97	5.85
4. Side Effects
Unemployed	2.13	0.66	0.14	3.21	0.001	0.83	3.44	F(3, 468)14.05	<0.001	0.083	0.077
Uses ≥five medicines	1.35	0.36	0.17	3.75	<0.001	0.64	2.05
Uses medicines ≥3x daily	1.41	0.42	0.15	3.41	0.001	0.60	2.23
Constant	9.17	0.28	.	32.97	<0.001	8.63	9.72
5. Lack of effect
University educated	−0.70	0.36	−0.09	−1.94	0.053	−1.41	0.01	F(1,470)3.75	0.053	0.008	−0.006
Constant	13.58	0.24		57.47	<0.001	13.12	14.04
6. Concerns
18–29 years-old	2.61	0.77	0.15	3.37	0.001	1.09	4.13	F(5,466)8.27	<0.001	0.082	0.072
European	−1.95	0.74	−0.12	−2.63	0.009	−3.41	−0.50
Unemployed	2.07	0.86	0.11	2.40	0.017	0.38	3.77
University educated	−1.29	0.47	−0.12	−2.74	0.006	−2.21	−0.36
Uses ≥five medicines	1.57	0.47	0.15	3.35	0.001	0.65	2.48
Constant	21.25	0.80	.	26.61	<0.001	19.68	22.82
7. Interference
18–29 years-old	3.79	0.70	0.23	5.44	<0.001	2.42	5.17	F(6,465) 21.43	<0.001	0.217	0.207
Male	1.42	0.42	0.14	3.33	0.001	0.58	2.25
Unemployed	2.62	0.76	0.14	3.44	0.001	1.12	4.12
University educated	−1.37	0.41	−0.14	−3.30	0.001	−2.18	−0.55
Uses ≥five medicines	1.84	0.42	0.19	4.36	<0.001	1.01	2.66
Uses medicines ≥3x daily	2.84	0.49	0.25	5.85	<0.001	1.89	3.79
Constant	11.68	0.43	.	26.94	<0.001	10.83	12.54
8. Autonomy
Retired	1.29	0.24	0.24	5.39	<0.001	0.82	1.76	F(2,469) 23.91	<0.001	0.093	0.089
Uses medicines ≥3x daily	−1.12	0.28	−0.18	−4.00	<0.001	−1.66	−0.57
Constant	10.33	0.18	.	56.13	<0.001	9.97	10.69

Notes: Full domain names: 1: Relationships/communication with health professionals about medicines, 2: Practicalities, 3: Cost-related burden, 4: Side effect burden, 5: Lack of effectiveness, 6: Attitudes and concerns about medicines, 7: Impact and interference on day-to-day life, 8: Control and autonomy to vary routine.

Abbreviations: B, unstandardized coefficient; Beta, standardized coefficient.