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

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

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.

Citation

Penner, L. S., Armitage, C. J., Thornley, T., Whelan, P., Chuter, A., Allen, T., & Elliott, R. A. (2024). 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. Journal of Public Health, 32(2), 325-338. https://doi.org/10.1007/s10389-022-01813-0

• Journal Article Type: Article
• Acceptance Date: Dec 19, 2022
• Online Publication Date: Jan 19, 2023
• Publication Date: 2024-02
• Deposit Date: Jan 19, 2023
• Publicly Available Date: Jan 20, 2023
• Journal: Journal of Public Health
• Print ISSN: 0943-1853
• Electronic ISSN: 1613-2238
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 2
• Pages: 325-338
• DOI: https://doi.org/10.1007/s10389-022-01813-0
• Keywords: Public Health, Environmental and Occupational Health
• Public URL: https://nottingham-repository.worktribe.com/output/16227761
• Publisher URL: https://link.springer.com/article/10.1007/s10389-022-01813-0
• Additional Information: Received: 3 August 2022; Accepted: 19 December 2022; First Online: 19 January 2023; : ; : Ethical approval was obtained from a University of Manchester ethics committee (ref: 2021-11485-19655, 22/06/2021); : Participants gave informed consent by email at inclusion in the panel and online before the survey.; : Not applicable; : PW is a director and shareholder of CareLoop Health Ltd, a for-profit company that develops and markets digital therapeutics for mental health conditions; and a director and shareholder of Prism Life Ltd, a research and consultancy company.