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Zarotti N, Deane KHO, Ford CEL, Simpson J. Perceived control as a predictor of medication adherence in people with Parkinson's: a large-scale cross-sectional study. Disabil Rehabil 2024; 46:478-488. [PMID: 36824021 DOI: 10.1080/09638288.2023.2181409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 02/11/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Medication adherence is a multi-faceted construct associated with several positive consequences in people with chronic conditions. However, non-adherence currently represents a major issue in Parkinson's, potentially due to low perceptions of control. This study investigated the predictive ability of several aspects of perceived control on adherence in people with Parkinson's, while accounting for previously established predictors such as depression and medication variables. MATERIALS AND METHODS An online cross-sectional survey was carried out with 1210 adults with Parkinson's from 15 English-speaking countries. Demographic and clinical questions, as well as measures of depression, aspects of perceived control, and medication adherence were included. Pearson's correlations and a 4-block hierarchical regression analysis were performed to assess the relationship between the variables. RESULTS Perceived control explained a slightly higher amount of variance in medication adherence compared to medication variables when entered in the last block. Unexpectedly, depression was not significantly related with adherence. Internal locus of control was an independent negative predictor of adherence, while external dimensions of locus of control emerged as independent positive predictors. CONCLUSIONS In people with Parkinson's, perceptions of control may have a larger impact on adherence compared to medication variables. Implications for clinical practice and future research are discussed.Implications for RehabilitationPerceived control and depression are considered important constructs for medication adherence in Parkinson's, which in turn is often problematic for affected individuals.The specific predictive value of different aspects of perceived control on medication adherence in Parkinson's is currently unclear.This large-scale study found that perceptions of control may have a larger impact on adherence compared to medication variables, while depression was unrelated to it.A need for psychologically-informed interventions, person-centred approaches to medication management, and Parkinson-specific measures of adherence are highlighted.
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Affiliation(s)
- Nicolò Zarotti
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Catherine Elaine Longworth Ford
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Tosin MH, de Oliveira BGR, Goetz CG, Morisky D, McConvey V, Skorvanek M, Schrag A, Martinez‐Martin P, Stebbins GT. Rating Scales for Medication Adherence in Parkinson's Disease: A Systematic Review for Critique and Recommendations. Mov Disord Clin Pract 2023; 10:175-189. [PMID: 36825050 PMCID: PMC9941935 DOI: 10.1002/mdc3.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/27/2022] [Accepted: 09/06/2022] [Indexed: 11/12/2022] Open
Abstract
Background Behaviors interfering with medication adherence (MA) are common and often complex in Parkinson's disease (PD), negatively affecting quality of life and undermining the value of clinical trials. The Clinical Outcome Assessments (COA) Scientific Evaluation Committee of the International Parkinson and Movement Disorder Society (MDS) commissioned the assessment of MA rating scales to recommend the use in PD. Objective Critically review the measurement properties of rating scales used to assess MA in PD and to issue recommendations. Methods We conducted systematic review across seven databases to identify structured scales to assess MA in PD. Eligible studies were critically appraised for methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Risk of Bias checklist. Standards for good measurement properties of the selected scales were summarized narratively using the COSMIN, the MDS-COA Committee methodology, the World Health Organization concepts, and the Ascertaining Barriers to Compliance taxonomy. The certainty of the evidence was determined using the modified Grades of Recommendation, Assessment, Development and Evaluation approach with final assessments (highest to lowest) of "Recommended," "Suggested" and "Listed". Results Of the nine reviewed scales, none met the designation "Recommended". The Morisky Medication Adherence Scale (MMAS-8); Beliefs Related to Medications Adherence questionnaire, Beliefs about Medication Questionnaire, Medication Adherence Rating Scale, and Satisfaction with Information on Medicines Scale were rated "Suggested". Conclusions We suggest further work focusing on resolving the problems of the suggested scales or developing a new scale meeting all required criteria.
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Affiliation(s)
| | | | - Christopher G. Goetz
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Donald Morisky
- Department of Community Health SciencesUCLA Fieldling School of Public HealthLos AngelesCaliforniaUSA
| | | | - Matej Skorvanek
- Department of Neurology, Faculty of MedicineP. J. Safarik UniversityKosiceSlovak Republic
- Department of NeurologyUniversity Hospital L. PasteurKosiceSlovak Republic
| | - Anette Schrag
- Department of Clinical NeurosciencesUCL Institute of NeurologyLondonLondonUK
| | - Pablo Martinez‐Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED)Carlos III Institute of HealthMadridSpain
| | - Glenn T. Stebbins
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
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Ronconi G, Calabria S, Piccinni C, Dondi L, Pedrini A, Esposito I, Addesi A, Sambati L, Martini N. Prescription Pattern of Monoamine Oxidase B Inhibitors Combined with Levodopa: A Retrospective Observational Analysis of Italian Healthcare Administrative Databases. Drugs Real World Outcomes 2022; 9:391-401. [PMID: 35696024 PMCID: PMC9392820 DOI: 10.1007/s40801-022-00308-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 11/27/2022] Open
Abstract
Background Parkinson’s disease is still incurable, and several factors are considered when defining pharmacological therapy. Objective The aim of this study was to describe the prescription pattern of monoamine oxidase B inhibitors (MAO-BIs) marketed in Italy (selegiline, rasagiline, safinamide) as an add-on to levodopa among new users of MAO-BIs, from the perspective of the Italian National Health Service. Patients and Methods Through cross-linkage of administrative healthcare data in the Ricerca e Salute (ReS) database, adults with a supply of one or more MAO-BIs in 2017, and with no other MAO-BI use since 2013, were selected. Levodopa had to be supplied within 30 days before/after the MAO-BI. The incidence, use, sex, age, comorbidities, 2-year prescription patterns (i.e., switches, proportion of treated patients per semester/year, mean daily milligrams/monthly tablets supplied, discontinuation, change to other anti-Parkinson drug) of patients taking MAO-BIs were provided. Results In 2017, 1059 new users received an MAO-BI (incidence 22.6 × 100,000 adults) combined with levodopa: 502 subjects (10.7 × 100,000) were treated with selegiline, 161 (3.4 × 100,000) were treated with rasagiline, and 396 (8.4 × 100,000) were treated with safinamide. The cohorts mainly consisted of males with a median age of ≥ 74 years. Treatment incidences increased with age. Switches occurred in 18.0%, 11.0%, and 4.3% of the selegiline, rasagiline, and safinamide cohorts, respectively. Most of the patients switching from selegiline/safinamide changed to rasagiline, while most of the patients switching from rasagiline changed to safinamide. From the first to second years, patient numbers reduced by ≤ 50%, and the daily milligrams/monthly tablets slightly increased. Six-month discontinuation occurred in > 50% of all cohorts, and ≥ 65% of discontinuing patients changed to another anti-Parkinson drug. Conclusions This analysis described the heterogeneous use of MAO-BIs as an add-on to levodopa in Italy. Further clinical trials and real-world studies are encouraged to update the few existing guidelines and to align clinical practice strategies. Supplementary Information The online version contains supplementary material available at 10.1007/s40801-022-00308-4.
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Affiliation(s)
- Giulia Ronconi
- Fondazione ReS (Ricerca e Salute), Research and Health Foundation, Casalecchio di Reno, Via Magnanelli 6/3, 40033, Bologna, Italy
| | - Silvia Calabria
- Fondazione ReS (Ricerca e Salute), Research and Health Foundation, Casalecchio di Reno, Via Magnanelli 6/3, 40033, Bologna, Italy.
| | - Carlo Piccinni
- Fondazione ReS (Ricerca e Salute), Research and Health Foundation, Casalecchio di Reno, Via Magnanelli 6/3, 40033, Bologna, Italy
| | - Letizia Dondi
- Fondazione ReS (Ricerca e Salute), Research and Health Foundation, Casalecchio di Reno, Via Magnanelli 6/3, 40033, Bologna, Italy
| | - Antonella Pedrini
- Fondazione ReS (Ricerca e Salute), Research and Health Foundation, Casalecchio di Reno, Via Magnanelli 6/3, 40033, Bologna, Italy
| | | | | | - Luisa Sambati
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Nello Martini
- Fondazione ReS (Ricerca e Salute), Research and Health Foundation, Casalecchio di Reno, Via Magnanelli 6/3, 40033, Bologna, Italy
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Zipprich HM, Mendorf S, Schönenberg A, Prell T. The impact of poor medication knowledge on health-related quality of life in people with Parkinson's disease: a mediation analysis. Qual Life Res 2021; 31:1473-1482. [PMID: 34797508 PMCID: PMC9023397 DOI: 10.1007/s11136-021-03024-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE This study aimed to determine how limited medication knowledge as one aspect of health literacy contributes to poorer health-related quality of life (HRQoL) in people with Parkinson's disease (PD). METHODS Demographical data, PD-specific data (MDS-Unified Parkinson's Disease-Rating Scale, Nonmotor symptom scale), and data about depressive symptoms (Beck's depression inventory), cognition (Montreal cognitive assessment), HRQoL (Short-Form Health Questionnaire-36, SF-36), and medication knowledge (names, time of taking, indication, dosage) were assessed in 193 patients with PD. Multivariate analysis of variance (MANOVA), multivariate analysis of covariance, and mediation analyses were used to study the relationship between medication knowledge and HRQoL in combination with different mediators and covariates. RESULTS Overall, 43.5% patients showed deficits in at least one of the 4 knowledge items, which was associated with higher age, number of medications per day and depression level, and poorer cognitive function, motor function, and lower education level. Using one-way MANOVA, we identified that medication knowledge significantly impacts physical functioning, social functioning, role limitations due to physical problems, and role limitations due to emotional problems. Mediation models using age, education level, and gender as covariates showed that the relationship between knowledge and SF-36 domains was fully mediated by Beck's Depression Inventory but not by Montreal Cognitive Assessment. CONCLUSIONS Patients who expressed unawareness of their medication did not necessarily have cognitive deficits; however, depressive symptoms may instead be present. This concomitant depressive symptomatology is crucial in explaining the contribution of nonadherence and decreased medication knowledge to poor quality of life.
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Affiliation(s)
- Hannah M Zipprich
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
| | - Sarah Mendorf
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
| | - Aline Schönenberg
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Tino Prell
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
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Tosin MHS, de Oliveira BGRB, Goetz CG, Morisky D, McConvey V, Stebbins GT. Rating scales for medication adherence in people living with Parkinson's disease: a systematic review protocol. JBI Evid Synth 2021; 20:260-269. [PMID: 34446669 DOI: 10.11124/jbies-21-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of the review is to evaluate the measurement properties of rating scales that have been used to assess the components of medication adherence in patients with Parkinson's disease. INTRODUCTION Drug therapy is a central strategy in the control of Parkinson's disease symptoms. Measuring behaviors related to medication adherence in patients with Parkinson's disease is vital to understanding the therapeutic response, making it necessary to define which instrument offers the most reliable and valid screening. INCLUSION CRITERIA Studies in English and Portuguese using structured rating scales to assess medication adherence in people with Parkinson's disease will be included. Studies including data from patients with different diseases in addition to Parkinson's disease, will be included only if data are clearly available for each disorder covered. Study protocols, letters to the editors, reviews, and studies with clinical judgment scales but no operationally defined anchor points will be excluded. METHODS A three-step search strategy will be utilized. Databases that will be utilized are MEDLINE (PubMed), LILACS (BVS Portal), PsycINFO (APA PsycNet), CINAHL (EBSCO), Web of Science (Clarivate Analytics), Embase, and Scopus (Elsevier). The search strategy will be presented using a PRISMA flow diagram. Eligible studies will be critically appraised for methodological quality using the COSMIN Risk of Bias checklist. Criteria for good measurement properties of the selected scales will be summarized narratively using COSMIN, the Movement Disorder Society Rating Scale Program Committee methodology, the World Health Organization concepts, and the ABC taxonomy of medication adherence. The certainty of the evidence will be determined using the modified GRADE. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42021211099).
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Affiliation(s)
- Michelle Hyczy S Tosin
- Department of Nursing, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States The Brazilian Centre for Evidence-based Healthcare: A JBI Centre of Excellence, São Paulo, Brazil UCLA Fielding School of Public Health, Los Angeles, CA, United States Parkinson's Victoria, Melbourne, Vic, Australia
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Franke GH, Nentzl J, Jagla-Franke M, Prell T. Medication Adherence and Coping with Disease in Patients from a Neurological Clinic: An Observational Study. Patient Prefer Adherence 2021; 15:1439-1449. [PMID: 34234417 PMCID: PMC8253891 DOI: 10.2147/ppa.s311946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/05/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Medication non-adherence is a huge concern for the medical community. For chronic, especially neurological diseases, taking medication is a central pillar of treatment. To improve adherence to these oftentimes complex medication regimens, the construct needs to be understood in more depth. The aim of this study was to investigate associations between adherence with sociodemographics, clinical variables, and coping in neurological patients. PATIENTS AND METHODS The sample consisted of 545 patients from a German neurological clinic. Adherence was assessed with the Stendal Adherence to Medication Score (SAMS). Patients were grouped as completely adherent (SAMS = 0), non-adherent (upper 25% of the sample), and moderately adherent. Associations with coping were assessed using the Essen Coping Questionnaire. RESULTS Medication adherence was low compared to other non-neurological patient samples. Differences between adherence groups were found regarding gender and facets of coping, namely "trivialisation, wishful thinking and defence" and "finding of inner stability". CONCLUSION Interventions to improve medication adherence should focus on facets of coping with disease, increasing acceptance of disease, willpower, and confidence in treatment.
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Affiliation(s)
- Gabriele Helga Franke
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Julia Nentzl
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Melanie Jagla-Franke
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany
- Center for Healthy Ageing, Jena University Hospital, Jena, Germany
- Correspondence: Tino Prell Department of Neurology, Jena University Hospital, Jena, Germany Email
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