Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework.
<h4>Background</h4>Patients' beliefs about treatment influence treatment engagement and adherence. The Necessity-Concerns Framework postulates that adherence is influenced by implicit judgements of personal need for the treatment (necessity beliefs) and concerns about the potential...
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
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| author | Rob Horne Sarah C E Chapman Rhian Parham Nick Freemantle Alastair Forbes Vanessa Cooper |
| author_facet | Rob Horne Sarah C E Chapman Rhian Parham Nick Freemantle Alastair Forbes Vanessa Cooper |
| author_sort | Rob Horne |
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| description | <h4>Background</h4>Patients' beliefs about treatment influence treatment engagement and adherence. The Necessity-Concerns Framework postulates that adherence is influenced by implicit judgements of personal need for the treatment (necessity beliefs) and concerns about the potential adverse consequences of taking it.<h4>Objective</h4>To assess the utility of the NCF in explaining nonadherence to prescribed medicines.<h4>Data sources</h4>We searched EMBASE, Medline, PsycInfo, CDSR/DARE/CCT and CINAHL from January 1999 to April 2013 and handsearched reference sections from relevant articles.<h4>Study eligibility criteria</h4>Studies using the Beliefs about Medicines Questionnaire (BMQ) to examine perceptions of personal necessity for medication and concerns about potential adverse effects, in relation to a measure of adherence to medication.<h4>Participants</h4>Patients with long-term conditions.<h4>Study appraisal and synthesis methods</h4>Systematic review and meta-analysis of methodological quality was assessed by two independent reviewers. We pooled odds ratios for adherence using random effects models.<h4>Results</h4>We identified 3777 studies, of which 94 (N = 25,072) fulfilled the inclusion criteria. Across studies, higher adherence was associated with stronger perceptions of necessity of treatment, OR = 1.742, 95% CI [1.569, 1.934], p<0.0001, and fewer Concerns about treatment, OR = 0.504, 95% CI: [0.450, 0.564], p<0.0001. These relationships remained significant when data were stratified by study size, the country in which the research was conducted and the type of adherence measure used.<h4>Limitations</h4>Few prospective longitudinal studies using objective adherence measures were identified.<h4>Conclusions</h4>The Necessity-Concerns Framework is a useful conceptual model for understanding patients' perspectives on prescribed medicines. Taking account of patients' necessity beliefs and concerns could enhance the quality of prescribing by helping clinicians to engage patients in treatment decisions and support optimal adherence to appropriate prescriptions. |
| format | Article |
| id | doaj-art-95d7dfd7f41f4bf587b3c319cda53d7a |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-95d7dfd7f41f4bf587b3c319cda53d7a2025-08-20T03:17:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01812e8063310.1371/journal.pone.0080633Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework.Rob HorneSarah C E ChapmanRhian ParhamNick FreemantleAlastair ForbesVanessa Cooper<h4>Background</h4>Patients' beliefs about treatment influence treatment engagement and adherence. The Necessity-Concerns Framework postulates that adherence is influenced by implicit judgements of personal need for the treatment (necessity beliefs) and concerns about the potential adverse consequences of taking it.<h4>Objective</h4>To assess the utility of the NCF in explaining nonadherence to prescribed medicines.<h4>Data sources</h4>We searched EMBASE, Medline, PsycInfo, CDSR/DARE/CCT and CINAHL from January 1999 to April 2013 and handsearched reference sections from relevant articles.<h4>Study eligibility criteria</h4>Studies using the Beliefs about Medicines Questionnaire (BMQ) to examine perceptions of personal necessity for medication and concerns about potential adverse effects, in relation to a measure of adherence to medication.<h4>Participants</h4>Patients with long-term conditions.<h4>Study appraisal and synthesis methods</h4>Systematic review and meta-analysis of methodological quality was assessed by two independent reviewers. We pooled odds ratios for adherence using random effects models.<h4>Results</h4>We identified 3777 studies, of which 94 (N = 25,072) fulfilled the inclusion criteria. Across studies, higher adherence was associated with stronger perceptions of necessity of treatment, OR = 1.742, 95% CI [1.569, 1.934], p<0.0001, and fewer Concerns about treatment, OR = 0.504, 95% CI: [0.450, 0.564], p<0.0001. These relationships remained significant when data were stratified by study size, the country in which the research was conducted and the type of adherence measure used.<h4>Limitations</h4>Few prospective longitudinal studies using objective adherence measures were identified.<h4>Conclusions</h4>The Necessity-Concerns Framework is a useful conceptual model for understanding patients' perspectives on prescribed medicines. Taking account of patients' necessity beliefs and concerns could enhance the quality of prescribing by helping clinicians to engage patients in treatment decisions and support optimal adherence to appropriate prescriptions.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0080633&type=printable |
| spellingShingle | Rob Horne Sarah C E Chapman Rhian Parham Nick Freemantle Alastair Forbes Vanessa Cooper Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PLoS ONE |
| title | Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. |
| title_full | Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. |
| title_fullStr | Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. |
| title_full_unstemmed | Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. |
| title_short | Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. |
| title_sort | understanding patients adherence related beliefs about medicines prescribed for long term conditions a meta analytic review of the necessity concerns framework |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0080633&type=printable |
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