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Abstract

Background Limited research exists exploring the influence of personality on adherence behaviour. Since non-adherence is a major obstacle in treating prevalent chronic diseases the aim was to determine whether personality traits are related to reported adherence to medication in individuals with chronic disease. Methodology/Principal Findings Individuals with chronic disease (n = 749) were identified in a random population sample of 5000 inhabitants aged 30–70 in two municipalities in West Sweden. Data on five personality traits, Neuroticism, Extraversion, Openness to experiences, Agreeableness, and Conscientiousness, and medication adherence behaviour was collected by questionnaires. Statistical analyses resulted in a negative relationship between Neuroticism and medication adherence (P<0.001), while both Agreeableness (P<0.001) and Conscientiousness (P<0.001) were positively related to adherence. At high levels of Conscientiousness, low adherence was related to higher scores in Neuroticism. At high levels of Agreeableness, low adherence was related to low scores in Conscientiousness and high scores in Openness to experiences. Conclusions This study demonstrated that multiple personality traits are of significant importance for adherence behaviour in individuals with chronic disease. The findings suggest that several personality traits may interact in influencing adherence behaviour. Personality traits could putatively be used to focus efforts to educate and support patients with high risk of low medical adherence.

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Medication nonadherence is associated with a broad range of adverse outcomes in patients with coronary artery disease.

Pamela N Peterson, Richard K. Olson, Susan M Shetterly … (2008)

Little is known about the effect of nonadherence among patients with coronary artery disease (CAD) on a broad spectrum of outcomes including cardiovascular mortality, cardiovascular hospitalizations, and revascularization procedures. This was a retrospective cohort study of 15,767 patients with CAD. Medication adherence was calculated as proportion of days covered for filled prescriptions of beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and statin medications. Multivariable Cox regression assessed the association between medication nonadherence as a time-varying covariate and a broad range of outcomes, adjusting for demographics and clinical characteristics. Median follow-up was 4.1 years. Rates of medication nonadherence were 28.8% for beta-blockers, 21.6% for ACE inhibitors, and 26.0% for statins. In unadjusted analysis, nonadherence to each class of medication was associated with higher all-cause and cardiovascular mortality. In multivariable analysis, nonadherence remained significantly associated with increased all-cause mortality risk for beta-blockers (hazard ratio [HR] 1.50, 95% CI 1.33-1.71), ACE inhibitors (HR 1.74, 95% CI 1.52-1.98), and statins (HR 1.85, 95% CI 1.63-2.09). In addition, nonadherence remained significantly associated with higher risk of cardiovascular mortality for beta-blockers (HR 1.53, 95% CI 1.16-2.01), ACE inhibitors (HR 1.66, 95% CI 1.26-2.20), and statins (HR 1.62, 95% CI 1.124-2.13). The findings of increased risk associated with nonadherence were consistent for cardiovascular hospitalization and revascularization procedures. Nonadherence to cardioprotective medications is common in clinical practice and associated with a broad range of adverse outcomes. These findings suggest that medication nonadherence should be a target for quality improvement interventions to maximize the outcomes of patients with CAD.

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Smoking and the Five-Factor Model of personality.

Érico Costa, Antonio Terracciano (2004)

Investigating the association between personality traits and smoking status using a comprehensive model of personality, the Five-Factor Model (FFM). Cross-sectional survey. Setting Baltimore, MD, USA. Participants Adult elderly Americans (n = 1638). A self-administered survey on cigarette smoking and the Revised NEO Personality Inventory (NEO-PI-R). Current smokers scored higher than never smokers on neuroticism and lower on agreeableness and conscientiousness; former smokers scored intermediate on these higher-order dimensions. Neuroticism was related to smoking particularly among individuals with low conscientiousness, as indicated by an interaction effect between the two factors. There were no differences on extraversion and openness to experience. At the lower-order facet level, smokers were characterized by inability to resist cravings (high impulsiveness), search for stimulation (high excitement-seeking), lack of perseverance (low self-discipline) and lack of careful consideration of the consequences of their actions (low deliberation). At the higher-order factor level, this study replicates and extends previous studies using a comprehensive model of personality (FFM). The greater specificity provided by the facet-level analysis appears to explain some of the conflicting results in the literature, and the use of an older sample provides insight especially into the former smokers group. Personality research may lead to a deeper understanding of cigarette smoking and can potentially contribute to policies and programs of smoking prevention and cessation.

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Treatment adherence in multiple sclerosis: association with emotional status, personality, and cognition.

Sharon Lynch, Warwick J M Bruce, Stuart Hancock … (2010)

The purpose of the present study was to prospectively examine the association between treatment adherence and common neuropsychiatric symptoms in multiple sclerosis (MS). Patients underwent a thorough psychiatric and neuropsychological evaluation at the outset of the study. Patient adherence to disease modifying therapies was then tracked for 8 weeks using self-report, a medication diary, and an electronic monitoring device that recorded needle disposals. Results indicated that MS patients with current mood or anxiety disorders were almost five times as likely as MS patients with no psychiatric diagnosis to exhibit problems adhering to their disease modifying therapies. Poor adherence was also associated with memory difficulties, anxiety, depression, neuroticism, and low conscientiousness. Findings highlight the importance of conducting a thorough psychiatric and neuropsychological evaluation when clinicians suspect poor adherence to disease modifying therapies. Pharmacological or psychotherapeutic treatment of mood/anxiety disorders, use of scheduled reminders, and/or increased organization and structure may lead to improved treatment adherence in MS.