What affected UK adults' adherence to medicines during the COVID-19 pandemic? Cross-sectional survey in a representative sample of people with long-term conditions

L S Penner; C J Armitage; T Thornley; P Whelan; A Chuter; T Allen; R A Elliott

doi:10.1007/s10389-022-01813-0

What affected UK adults' adherence to medicines during the COVID-19 pandemic? Cross-sectional survey in a representative sample of people with long-term conditions

Z Gesundh Wiss. 2023 Jan 19:1-14. doi: 10.1007/s10389-022-01813-0. Online ahead of print.

Authors

L S Penner^{1

2}, C J Armitage³, T Thornley⁴, P Whelan⁵, A Chuter², T Allen^{2

6}, R A Elliott²

Affiliations

¹ Janssen-Cilag GmbH, Johnson & Johnson Platz 1, 41470 Neuss, Germany.
² Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, 4th Floor, Jean McFarlane Building, Manchester, M13 9PL UK.
³ Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Coupland Building 1, Manchester, M13 9PL; Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, M13 9PT; NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Coupland Building 1, Manchester, M13 9PL UK.
⁴ School of Pharmacy, University of Nottingham, University Park, Nottingham, NG7 2RD UK.
⁵ Digital Health Technical Lead, Centre for Health Informatics, Division of Informatics, Imaging and Data Science| School of Health Sciences | Faculty of Biology, Medicine and Health, University of Manchester, Vaughan House, Manchester, M13 9PL UK.
⁶ Danish Centre for Health Economics, University of Southern Denmark, Odense, Denmark.

Abstract

Aim: Medicines non-adherence is associated with poorer outcomes and higher costs. COVID-19 affected access to healthcare, with increased reliance on remote methods, including medicines supply. This study aimed to identify what affected people's adherence to medicines for long-term conditions (LTCs) during the pandemic.

Subject and methods: Cross-sectional online survey of UK adults prescribed medicines for LTCs assessing self-reported medicines adherence, reasons for non-adherence (using the capability, opportunity and motivation model of behaviour [COM-B]), medicines access and COVID-19-related behaviours.

Results: The 1746 respondents reported a mean (SD) of 2.5 (1.9) LTCs, for which they were taking 2.4 (1.9) prescribed medicines, 525 (30.1%) reported using digital tools to support ordering or taking medicines and 22.6% reported medicines non-adherence. No access to at least one medicine was reported by 182 (10.4%) respondents; 1048 (60.0%) reported taking at least one non-prescription medicine as a substitute; 409 (23.4%) requested emergency supply from pharmacy for at least one medicine. Problems accessing medicines, being younger, male, in the highest socioeconomic group and working were linked to poorer adherence. Access problems were mostly directly or indirectly related to the COVID-19 pandemic. Respondents were generally lacking in capabilities and opportunities, but disruptions to habits (automatic motivation) was the major reason for non-adherence.

Conclusion: Navigating changes in how medicines were accessed, and disruption of habits during the COVID-19 pandemic, was associated with suboptimal adherence. People were resourceful in overcoming barriers to access. Solutions to support medicines-taking need to take account of the multiple ways that medicines are prescribed and supplied remotely.

Supplementary information: The online version contains supplementary material available at 10.1007/s10389-022-01813-0.

Keywords: Behaviour and behaviour mechanisms; COVID-19; Community pharmacy services; Primary healthcare; Treatment adherence and compliance.