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Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework

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

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

Suggested Citation

  • Rob Horne & Sarah C E Chapman & Rhian Parham & Nick Freemantle & Alastair Forbes & Vanessa Cooper, 2013. "Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-24, December.
    • Handle: RePEc:plo:pone00:0080633
    DOI: 10.1371/journal.pone.0080633
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    References listed on IDEAS

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    1. Horne, Robert & Graupner, Lída & Frost, Susie & Weinman, John & Wright, Siobhan Melanie & Hankins, Matthew, 2004. "Medicine in a multi-cultural society: the effect of cultural background on beliefs about medications," Social Science & Medicine, Elsevier, vol. 59(6), pages 1307-1313, September.
    2. Calnan, Michael & Montaner, David & Horne, Rob, 2005. "How acceptable are innovative health-care technologies? A survey of public beliefs and attitudes in England and Wales," Social Science & Medicine, Elsevier, vol. 60(9), pages 1937-1948, May.
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    1. Prati, Alberto & Saucet, Charlotte, 2024. "The causal effect of a health treatment on beliefs, stated preferences and memories," Journal of Health Economics, Elsevier, vol. 94(C).
    2. Upasak Das & Prasenjit Sarkhel & Sania Ashraf, 2022. "Love Thy Neighbour? Perceived Community Abidance and Private Compliance to COVID-19 Norms in India," South Asia Economic Journal, Institute of Policy Studies of Sri Lanka, vol. 23(1), pages 30-51, March.
    3. Phaviga Thangsuk & Kanokporn Pinyopornpanish & Wichuda Jiraporncharoen & Nida Buawangpong & Chaisiri Angkurawaranon, 2021. "Is the Association between Herbal Use and Blood-Pressure Control Mediated by Medication Adherence? A Cross-Sectional Study in Primary Care," IJERPH, MDPI, vol. 18(24), pages 1-8, December.
    4. Grabowski, David C. & Fishman, Jesse & Wild, Imane & Lavin, Bruce, 2018. "Changing the neurology policy landscape in the United States: Misconceptions and facts about epilepsy," Health Policy, Elsevier, vol. 122(7), pages 797-802.

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