The influence of beliefs about medicines on medication nonadherence among hemodialysis patients: a multicenter study from Malaysia

INTRODUCTION: Medication nonadherence can be caused by erroneous medication beliefs. This study aimed to assess the prevalence of medication nonadherence among hemodialysis patients and its association with beliefs about medicines.
METHODS: A cross-sectional multicenter study among hemodialysis patients was performed. Data was collected by using the 5 items-medication adherence report scale (MARS-5) and the Beliefs about Medicine Questionnaire (BMQ). The correlation of medication nonadherence with patients’ beliefs about medicine was assessed by multiple logistic regression.
RESULTS: A total of 325 patients were interviewed. The majority of patients were aged 55 years or more (69.0%) and received 6-10 prescribed medications daily (58.1%). The prevalence of medication nonadherence was 69.5% based on the MARS-5 score. Considering the BMQ score, the total mean score for the Specific–Necessity and Specific–Concern domain was 18.42 ± 2.30 and 13.16 ± 3.13 respectively. Whereas, the General–Overuse and the General–Harm domains showed a total mean score of 11.37 ± 1.98 and 9.44 ± 1.81 respectively. The patients with the belief of medication will protect them from becoming worse showed significantly less medication nonadherence (adjusted OR = 0.543). Medication nonadherence was significantly more prominent among patients who worried about taking medications (adjusted OR = 1.500) but less prominent among patients who perceived medications as addictive to them (adjusted OR = 0.637).
DISCUSSION AND CONCLUSION: In conclusion, medication nonadherence was prevalent among hemodialysis patients. There is a need to address hemodialysis patients’ necessity, concern, and harm perception towards their prescribed medication to overcome medication nonadherence.