Display options
Cite
Horne R, Chapman SC, Parham R, et al. Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PLoS One. 2013;8(12):e80633doi: 10.1371/journal.pone.0080633.
Horne, R., Chapman, S. C., Parham, R., Freemantle, N., Forbes, A., & Cooper, V. (2013). Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PloS one, 8(12), e80633. https://doi.org/10.1371/journal.pone.0080633
Horne, Rob, et al. "Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework." PloS one vol. 8,12 (2013): e80633. doi: https://doi.org/10.1371/journal.pone.0080633
Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V. Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PLoS One. 2013 Dec 02;8(12):e80633. doi: 10.1371/journal.pone.0080633. eCollection 2013. PMID: 24312488; PMCID: PMC3846635.
Copy Download .nbib Format: NLM
Share it on

PLoS One. 2013 Dec 02;8(12):e80633. doi: 10.1371/journal.pone.0080633. eCollection 2013.

Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework.

PloS one

Rob Horne, Sarah C E Chapman, Rhian Parham, Nick Freemantle, Alastair Forbes, Vanessa Cooper

Affiliations

  1. Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom.

PMID: 24312488 PMCID: PMC3846635 DOI: 10.1371/journal.pone.0080633

Abstract

BACKGROUND: 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.

OBJECTIVE: To assess the utility of the NCF in explaining nonadherence to prescribed medicines.

DATA SOURCES: We searched EMBASE, Medline, PsycInfo, CDSR/DARE/CCT and CINAHL from January 1999 to April 2013 and handsearched reference sections from relevant articles.

STUDY ELIGIBILITY CRITERIA: 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.

PARTICIPANTS: Patients with long-term conditions.

STUDY APPRAISAL AND SYNTHESIS METHODS: Systematic review and meta-analysis of methodological quality was assessed by two independent reviewers. We pooled odds ratios for adherence using random effects models.

RESULTS: 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.

LIMITATIONS: Few prospective longitudinal studies using objective adherence measures were identified.

CONCLUSIONS: 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.

References

  1. Int J Geriatr Psychiatry. 2002 Aug;17(8):752-7 - PubMed
  2. Ann Pharmacother. 2008 Jan;42(1):39-45 - PubMed
  3. J Acquir Immune Defic Syndr. 2008 Dec 1;49(4):460-2 - PubMed
  4. Int J STD AIDS. 2004 Jan;15(1):38-44 - PubMed
  5. Int J STD AIDS. 2001 Feb;12(2):103-7 - PubMed
  6. Intern Med J. 2012 Jun;42(6):e136-44 - PubMed
  7. Ann Pharmacother. 2005 Nov;39(11):1792-7 - PubMed
  8. BMC Health Serv Res. 2012 Jun 14;12:98 - PubMed
  9. J Hum Hypertens. 2004 Sep;18(9):607-13 - PubMed
  10. Ann Pharmacother. 2006 Oct;40(10):1737-42 - PubMed
  11. Rheumatol Int. 2010 Sep;30(11):1441-8 - PubMed
  12. Med Care. 2005 Dec;43(12):1203-7 - PubMed
  13. Psychol Health Med. 2007 Jan;12(1):107-13 - PubMed
  14. Ann Pharmacother. 2008 Feb;42(2):192-9 - PubMed
  15. Br J Clin Pharmacol. 2007 Apr;63(4):488-93 - PubMed
  16. J Psychosom Res. 2005 May;58(5):403-15 - PubMed
  17. Prim Care Respir J. 2011 Jun;20(2):141-7 - PubMed
  18. N Z Med J. 2008 Nov 07;121(1286):14-20 - PubMed
  19. Clin Ther. 2011 Sep;33(9):1180-9 - PubMed
  20. J Adolesc Health. 2011 Jun;48(6):637-40 - PubMed
  21. Patient Educ Couns. 2008 Nov;73(2):371-6 - PubMed
  22. Patient Prefer Adherence. 2012;6:389-94 - PubMed
  23. Pharm World Sci. 2010 Aug;32(4):432-9 - PubMed
  24. Value Health. 2011 Dec;14(8):1092-100 - PubMed
  25. Pediatr Transplant. 2006 Sep;10(6):694-700 - PubMed
  26. Am Heart J. 2011 Apr;161(4):673-80 - PubMed
  27. Clin J Pain. 2001 Sep;17(3):245-8 - PubMed
  28. J Behav Med. 2010 Dec;33(6):432-40 - PubMed
  29. J Affect Disord. 2009 Jul;116(1-2):51-5 - PubMed
  30. Schizophr Res. 2011 Oct;132(1):42-9 - PubMed
  31. Clin Ther. 2013 Feb;35(2):153-60 - PubMed
  32. J Health Care Poor Underserved. 2010 Feb;21(1):349-61 - PubMed
  33. Patient Educ Couns. 2006 Dec;64(1-3):151-8 - PubMed
  34. Community Ment Health J. 2010 Oct;46(5):452-60 - PubMed
  35. J Rheumatol. 2009 Oct;36(10):2164-70 - PubMed
  36. J Asthma. 2011 Nov;48(9):914-22 - PubMed
  37. Am Heart J. 2011 May;161(5):855-63 - PubMed
  38. Patient Educ Couns. 2005 Oct;59(1):97-102 - PubMed
  39. Int J STD AIDS. 2007 Jun;18(6):369-73 - PubMed
  40. N Z Med J. 2004 Jan 30;117(1188):U743 - PubMed
  41. AIDS Care. 2010 Jan;22(1):29-39 - PubMed
  42. J Eval Clin Pract. 2012 Apr;18(2):409-13 - PubMed
  43. Patient Prefer Adherence. 2012;6:741-8 - PubMed
  44. J Psychosom Res. 2011 Feb;70(2):179-87 - PubMed
  45. J Emerg Med. 2012 Nov;43(5):773-85 - PubMed
  46. Res Social Adm Pharm. 2013 Jul-Aug;9(4):446-57 - PubMed
  47. Eye (Lond). 2012 Mar;26(3):407-17 - PubMed
  48. BJU Int. 2010 May;105(9):1283-90 - PubMed
  49. Adm Policy Ment Health. 2011 Mar;38(2):86-95 - PubMed
  50. Cardiovasc Drugs Ther. 2007 Aug;21(4):311-6 - PubMed
  51. Acta Psychiatr Scand. 2009 Jan;119(1):78-84 - PubMed
  52. Patient Educ Couns. 2003 Nov;51(3):247-58 - PubMed
  53. J Gen Intern Med. 2013 Jan;28(1):99-106 - PubMed
  54. AIDS. 2007 Dec;21 Suppl 8:S149-55 - PubMed
  55. J Womens Health (Larchmt). 2012 Apr;21(4):440-6 - PubMed
  56. Transplantation. 2012 May 15;93(9):958-63 - PubMed
  57. J Gen Intern Med. 2013 Jan;28(1):67-73 - PubMed
  58. Soc Sci Med. 2004 Sep;59(6):1307-13 - PubMed
  59. Open Nurs J. 2012;6:41-6 - PubMed
  60. Patient Educ Couns. 2006 Aug;62(2):244-9 - PubMed
  61. Am J Health Syst Pharm. 2009 Apr 1;66(7):657-64 - PubMed
  62. Rheumatology (Oxford). 2005 Jun;44(6):762-7 - PubMed
  63. AIDS Behav. 2012 Aug;16(6):1511-21 - PubMed
  64. BMC Cancer. 2011 Jul 01;11:284 - PubMed
  65. Int J Behav Med. 2007;14(3):141-50 - PubMed
  66. Ann Fam Med. 2008 Jan-Feb;6(1):23-9 - PubMed
  67. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD000011 - PubMed
  68. Inflamm Bowel Dis. 2011 Sep;17(9):1874-81 - PubMed
  69. Health Qual Life Outcomes. 2012 Dec 07;10:148 - PubMed
  70. J Gen Intern Med. 2010 Aug;25(8):819-25 - PubMed
  71. J Am Board Fam Med. 2010 Mar-Apr;23(2):159-65 - PubMed
  72. Saudi Pharm J. 2010 Oct;18(4):225-32 - PubMed
  73. Int J Clin Pharm. 2012 Aug;34(4):618-25 - PubMed
  74. Ambul Pediatr. 2005 Sep-Oct;5(5):306-10 - PubMed
  75. Hum Psychopharmacol. 2012 Jan;27(1):57-62 - PubMed
  76. Patient Prefer Adherence. 2013;7:141-50 - PubMed
  77. Ann Allergy Asthma Immunol. 2010 Feb;104(2):132-8 - PubMed
  78. J Affect Disord. 2010 Nov;126(3):388-94 - PubMed
  79. Ann Behav Med. 2007 Aug;34(1):46-55 - PubMed
  80. Ann Behav Med. 2012 Aug;44(1):85-93 - PubMed
  81. Epilepsy Behav. 2011 Nov;22(3):584-6 - PubMed
  82. Int Psychogeriatr. 2012 Jan;24(1):159-69 - PubMed
  83. J Acquir Immune Defic Syndr. 2007 Jul 1;45(3):334-41 - PubMed
  84. Gen Hosp Psychiatry. 2012 May-Jun;34(3):221-6 - PubMed
  85. J Nerv Ment Dis. 2012 Jan;200(1):33-43 - PubMed
  86. Diabetes Care. 2009 Jan;32(1):19-24 - PubMed
  87. Curr Opin Anaesthesiol. 2007 Oct;20(5):435-9 - PubMed
  88. J Gen Intern Med. 2013 Mar;28(3):399-405 - PubMed
  89. J Glaucoma. 2014 Jun-Jul;23(5):293-8 - PubMed
  90. Int J Clin Pharm. 2012 Feb;34(1):53-62 - PubMed
  91. J Affect Disord. 2007 Jun;100(1-3):253-7 - PubMed
  92. Am Heart J. 2010 Apr;159(4):561-9 - PubMed
  93. Patient Prefer Adherence. 2011;5:389-96 - PubMed
  94. Schizophr Res. 2006 Mar;83(1):53-63 - PubMed
  95. Rev Invest Clin. 2011 Mar-Apr;63(2):155-61 - PubMed
  96. Nephrol Dial Transplant. 2004 Dec;19(12):3144-9 - PubMed
  97. J Asthma. 2011 Aug;48(6):616-24 - PubMed
  98. Eur Psychiatry. 2010 May;25(4):216-9 - PubMed
  99. Pediatrics. 2013 Apr;131(4):e1204-10 - PubMed
  100. J Psychosom Res. 2013 Apr;74(4):327-33 - PubMed
  101. Am J Gastroenterol. 2007 Jul;102(7):1417-26 - PubMed
  102. Res Social Adm Pharm. 2010 Dec;6(4):334-44 - PubMed
  103. Br J Health Psychol. 2012 Feb;17(1):74-84 - PubMed
  104. Patient Prefer Adherence. 2010 Jul 21;4:187-95 - PubMed
  105. Pain. 2004 Apr;108(3):276-283 - PubMed
  106. AIDS Care. 2011 Jun;23(6):705-13 - PubMed
  107. Arthritis Care Res (Hoboken). 2011 Mar;63(3):342-50 - PubMed
  108. Psychol Health. 2010 Jun;25(5):601-15 - PubMed
  109. AIDS Care. 2005 Apr;17(3):367-76 - PubMed
  110. J Oncol Pharm Pract. 2012 Sep;18(3):333-42 - PubMed
  111. Prim Care Companion J Clin Psychiatry. 2007;9(2):91-9 - PubMed
  112. J Affect Disord. 2004 Sep;81(3):287-91 - PubMed
  113. Diabetes Care. 2011 Feb;34(2):338-40 - PubMed
  114. Musculoskeletal Care. 2007 Sep;5(3):148-59 - PubMed
  115. BMC Neurol. 2010 Feb 24;10:15 - PubMed
  116. Hum Psychopharmacol. 2013 Mar;28(2):142-50 - PubMed
  117. BMJ. 2006 Jul 1;333(7557):15 - PubMed
  118. Br J Health Psychol. 2013 Nov;18(4):799-813 - PubMed
  119. Patient Educ Couns. 2011 May;83(2):265-8 - PubMed
  120. J Psychosom Res. 1999 Dec;47(6):555-67 - PubMed
  121. Eur J Emerg Med. 2001 Sep;8(3):181-8 - PubMed
  122. Can Fam Physician. 2013 Feb;59(2):e93-e100 - PubMed
  123. Circ Cardiovasc Qual Outcomes. 2010 Mar;3(2):173-80 - PubMed
  124. J Asthma. 2008 Jan-Feb;45(1):33-7 - PubMed
  125. Patient Educ Couns. 2013 Apr;91(1):105-12 - PubMed
  126. Rev Med Interne. 2012 Jun;33(6):300-4 - PubMed
  127. JAMA. 2000 Apr 19;283(15):2008-12 - PubMed
  128. Psychol Health. 2012;27(5):570-87 - PubMed
  129. BMC Med Res Methodol. 2011 Nov 03;11:149 - PubMed
  130. Int J Pharm Pract. 2010 Aug;18(4):217-25 - PubMed
  131. Diabetes Obes Metab. 2012 Dec;14(12):1081-7 - PubMed
  132. Ophthalmology. 2010 May;117(5):903-8 - PubMed
  133. Nephron Clin Pract. 2011;119(3):c205-13 - PubMed
  134. J Diabetes. 2012 Sep;4(3):243-7 - PubMed
  135. Singapore Med J. 2012 Jul;53(7):474-80 - PubMed
  136. Rheumatology (Oxford). 2008 May;47(5):690-7 - PubMed
  137. Patient Educ Couns. 2011 Jun;83(3):382-90 - PubMed
  138. Br J Gen Pract. 2012 Aug;62(601):e530-7 - PubMed
  139. J Behav Med. 2014 Apr;37(2):266-75 - PubMed
  140. Br J Health Psychol. 2013 Feb;18(1):18-30 - PubMed
  141. Diabetes Educ. 2012 May-Jun;38(3):397-408 - PubMed
  142. Res Social Adm Pharm. 2010 Sep;6(3):185-95 - PubMed
  143. J Psychosom Res. 2008 Jan;64(1):47-54 - PubMed
  144. Med Care. 2012 Dec;50(12):1013-9 - PubMed
  145. Lancet. 2012 May 19;379(9829):1860-1 - PubMed
  146. J Assoc Nurses AIDS Care. 2012 Nov-Dec;23(6):511-20 - PubMed
  147. BJU Int. 2010 May;105(9):1276-82 - PubMed
  148. Chronic Illn. 2010 Dec;6(4):243-51 - PubMed
  149. Neuropsychopharmacology. 2011 Jan;36(1):339-54 - PubMed
  150. Pain Med. 2013 Feb;14(2):247-56 - PubMed
  151. Scand J Rheumatol. 2011 May;40(3):192-6 - PubMed
  152. Health Psychol. 2011 Jan;30(1):31-9 - PubMed
  153. J Gen Intern Med. 2013 May;28(5):675-82 - PubMed
  154. Epidemiol Psichiatr Soc. 2010 Jan-Mar;19(1):86-92 - PubMed
  155. Clin Transplant. 2012 Sep-Oct;26(5):706-13 - PubMed
  156. Curr Med Res Opin. 2007 Dec;23(12):3137-52 - PubMed
  157. Chronic Illn. 2009 Jun;5(2):129-33 - PubMed
  158. Inflamm Bowel Dis. 2009 Jun;15(6):837-44 - PubMed
  159. Clin Genet. 2001 Oct;60(4):283-92 - PubMed
  160. Res Social Adm Pharm. 2009 Dec;5(4):363-75 - PubMed
  161. Am J Trop Med Hyg. 2008 Feb;78(2):283-8 - PubMed
  162. Behav Med. 2007 Winter;32(4):127-34 - PubMed
  163. Pharm World Sci. 2006 Aug;28(4):233-8 - PubMed
  164. J Pharm Pract. 2014 Feb;27(1):19-24 - PubMed
  165. Eur Heart J. 2006 Feb;27(4):434-40 - PubMed
  166. Pharm World Sci. 2006 Jun;28(3):165-70 - PubMed
  167. Ann Pharmacother. 2012 May;46(5):659-70 - PubMed
  168. Osteoporos Int. 2011 May;22(5):1493-501 - PubMed
  169. Patient Educ Couns. 2006 Feb;60(2):187-93 - PubMed
  170. Geriatr Nurs. 2012 Mar-Apr;33(2):89-95 - PubMed
  171. Patient Educ Couns. 2010 Jul;80(1):138-40 - PubMed
  172. Ann Fam Med. 2005 Jan-Feb;3(1):23-30 - PubMed
  173. Ann Pharmacother. 2010 Jan;44(1):70-9 - PubMed
  174. Ann Behav Med. 2011 Jun;41(3):383-90 - PubMed
  175. Pharm World Sci. 2008 Jan;30(1):17-23 - PubMed
  176. Chest. 2006 Mar;129(3):573-80 - PubMed
  177. BMC Psychiatry. 2013 Feb 20;13:65 - PubMed
  178. Liver Transpl. 2006 Dec;12(12):1862-8 - PubMed
  179. AIDS Care. 2013;25(9):1149-58 - PubMed
  180. AIDS Care. 2012;24(12):1470-9 - PubMed
  181. S D Med. 2011 Oct;64(10):365-8 - PubMed
  182. J Health Psychol. 2010 Sep;15(6):828-37 - PubMed
  183. Patient Prefer Adherence. 2012;6:789-804 - PubMed
  184. Invest Ophthalmol Vis Sci. 2012 Dec 17;53(13):8240-5 - PubMed
  185. J Int Assoc Provid AIDS Care. 2013 May-Jun;12(3):195-201 - PubMed
  186. Patient Educ Couns. 2007 Dec;69(1-3):158-64 - PubMed
  187. Soc Sci Med. 2005 May;60(9):1937-48 - PubMed
  188. Clin Ophthalmol. 2010 Dec 08;4:1489-96 - PubMed
  189. BMJ. 2011 Jul 22;343:d4002 - PubMed

MeSH terms

Publication Types

Grant support