Analysis of beliefs about medicines and medication adherence in patients with chronic diseases at the Military Medical Services, Nablus, Palestine

Background: very few studies in the Arab world investigated patients’ behavior toward medications, particularly in those with multiple co-morbid and different chronic diseases. Furthermore, most studies in this field were carried out among patients with governmental insurance which could affect the reliability and validity of the results since medications are not always available in governmental pharmacies. Objective: to investigate how the presence of multiple chronic illnesses could affect the association between attitudes toward medicines and adherence practices in a non-governmental settings. Methodology: The Palestinian Medical Military Services in Nablus, Palestine was the main setting for the study. Presence and number of multiple chronic diseases were obtained from patients through interview setting and were confirmed by information available at the medical files. Attitudes toward medicines were evaluated by the Beliefs about Medicines Questionnaire (BMQ) while compliance / adherence behavior was evaluated by Morisky Medication Adherence Scale (MMAS-8). Results: One hundred and eighty seven patients were interviewed. Most participants (79.6%) had positive attitude that their medicines were necessary to maintain their good health status while 58.2% of the study sample were afraid and had negative attitude or concern about taking medicines on regular basis and 57.8% were afraid that they will get addicted and become dependent on their medicines. In the presence of multiple chronic diseases, demographic and clinical factors were not significantly associated with adherence practices. However, in patients with multiple chronic diseases, those who had higher positive attitudes and feeling of necessity had higher odds [1.4 (1.1 - 1.9)] of having adherence practices while those who had higher negative attitudes or concerns or fear about medicines had lower odds [0.8 (0.65 – 0.98)] of having adherence practices. Conclusions: In patients with multiple chronic diseases, positive and negative attitudes toward medicines are significant determinant of adherence practices.