ORIGINAL PAPER
A weekend/weekday comparison of adherence to daily treatment regimens in adults with cystic fibrosis
 
More details
Hide details
 
Submission date: 2017-06-30
 
 
Final revision date: 2017-08-22
 
 
Acceptance date: 2017-09-23
 
 
Online publication date: 2017-12-21
 
 
Publication date: 2017-12-21
 
 
Health Psychology Report 2018;6(2):146-157
 
KEYWORDS
TOPICS
ABSTRACT
Background:
Treatment adherence is a major concern in cystic fibrosis (CF), with accumulating evidence that health outcomes are worse in patients with lower levels of adherence. This study investigates how adherence differs for adults with CF during a weekday and a weekend day by examining the roles of sex, anxiety, depression, and lung function as predictors of adherence.

Participants and procedure:
Fifty-two adult participants with CF were recruited. Demographics and spirometry results were recorded. Participants completed the Hospital Anxiety and Depression Scale and two daily phone diaries in order to record their adherence to pancreatic enzymes, vitamins, physiotherapy and exercise. Based on previous findings, it was hypothesised that reported adherence would be higher during the weekend in comparison to weekdays, due to lower time pressure during the weekend.

Results:
Paired sample t-tests indicated that overall participants had higher reported adherence during the weekend in comparison to weekdays, with sex, anxiety, depression and lung function being predictors of adherence.

Conclusions:
Clinical implications and future directions are discussed, with an emphasis on the need for further qualitative research. We are now conducting another research project utilising qualitative interviews with participants to further investigate adherence within the CF population. Our aim is to identify the main adherence barriers and to develop interventions to improve treatment adherence in the CF population.

 
REFERENCES (42)
1.
Abbott, J., Dodd, M., Bilton, D., & Webb, A. K. (1994). Treatment compliance in adults with cystic fibrosis. Thorax, 49, 115–120. doi: 10.1136/thx.49.2.115.
 
2.
Abbott, J., Dodd, M., & Webb, A. K. (1996). Health perceptions and treatment adherence in adults with cystic fibrosis. Thorax, 51, 1233–1238. doi: 10.1136/thx.51.12.1233.
 
3.
Abbott, J., Havermans, T., & Hart, A. (2009). Adherence to the medical regimen: clinical implications of new findings. Current Opinion in Pulmonary Medicine, 15, 597–603. doi: 10.1097/MCP.0b013e3283310859.
 
4.
Backström-Eriksson, L., Sorjonen, K., Bergsten-Brucefors, A., Hjelte, L., & Melin, B. (2015). Anxiety and depression in adults with cystic fibrosis: a comparison between patients and the general population in Sweden and three other European countries. BioMed Central Pulmonary Medicine, 15, 121. doi: 10.1186/s12890-015-0117-9.
 
5.
Ball, R., Southern, K. W., McCormack, P., Duff, A. J. A., Brownlee, K. G., & McNamara, P. S. (2013). Adherence to nebulised therapies in adolescents with cystic fibrosis is best on week-days during school term-time. Journal of Cystic Fibrosis, 12, 440–444. doi: 10.1016/j.jcf.2012.12.012.
 
6.
Barker, D. H., Driscoll, K. A., Modi, A. C., Light, M. J., & Quittner, A. L. (2012). Supporting cystic fibrosis disease management during adolescence: the role of family and friends. Child: Care, Health and Development, 38, 497–504. doi: 10.1111/j.1365-2214.2011.01286.x.
 
7.
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the hospital anxiety and depression scale. An updated literature review. Journal of Psychosomatic Research, 52, 69–77. doi: 10.1016/S0022-3999(01)00296-3.
 
8.
Bregnballe, V., Schiotz, P. O., Boisen, K. A., Pressler, T., & Thastum, M. (2011). Barriers to adherence in adolescents and young adults with cystic fibrosis: a questionnaire study in young patients and their parents. Patient Preference and Adherence, 5, 507–515. doi: 10.2147/PPA.S25308.
 
9.
Daniels, T., Goodacre, L., Sutton, C., Pollard, K., Conway, S., & Peckham, D. (2011). Accurate assessment of adherence: self-report and clinician report vs electronic monitoring of nebulizers. Chest, 140, 425–432. doi: 10.1378/chest.09-3074.
 
10.
Eakin, M. N., Bilderback, A., Boyle, M. P., Mogayzel, P. J., & Riekert, K. A. (2011). Longitudinal association between medication adherence and lung health in people with cystic fibrosis. Journal of Cystic Fibrosis, 10, 258–264. doi: 10.1016/j.jcf.2011.03.005.
 
11.
Hansson, M., Nordstom, A., & Bodlund, O. (2009). Comparison of two self-rating scales to detect depression: HADS and PHQ-9. The British Journal of General Practice, 59, 283–288. doi: 10.3399/bjgp09X454070.
 
12.
Harris, P. R., Sillence, E., & Briggs, P. (2011). Perceived threat and corroboration: key factors that improve a predictive model of trust in internet-based health information and advice. Journal of Medical Internet Research, 13, 1–16. doi: 10.2196/jmir.1821.
 
13.
Higham, L., Ahmed, S., & Ahmed, M. (2013). Hoping to live a “normal” life whilst living with unpredictable health and fear of death: impact of cystic fibrosis on young adults. Journal of Genetic Counselling, 22, 374–383. doi: 10.1007/s10897-012-9555-1.
 
14.
Hillard, M. E., Eakin, M. N., Borrelli, B., Green, A., & Riekert, K. A. (2014). Medication beliefs medicate between depressive symptoms and medication adherence in cystic fibrosis. Health Psychology, 34, 496–504. doi: 10.1037/hea0000136.
 
15.
Horne, R. (2000). Assessing perceptions of medications: psychological perspectives. In H. McGavock, Handbook of drug research methodology (pp. 299–319). Newcastle upon Tyne: United Kingdom Drug Utilisation Research Group.
 
16.
Horne, R., Weinman, J., Barber, N., Elliott, R. A., & Morgan, M. (2006). Concordance, adherence and compliance in medicine taking: a conceptual map and research priorities. Brighton, UK: National Co-ordinating Centre for NHS Service Delivery and Organisation R&D.
 
17.
Iacobucci, D., Posavac, S. S., Kardes, F. R., Schneider, M. J., & Popovich, D. L. (2014). Toward a more nuanced understanding of the statistical properties of a median split. Journal of Consumer Psychology, 25, 652–665. doi: 10.1016/j.jcps.2014.12.002.
 
18.
Kahneman, D., Krueger, A. B., Schkade, D. A., Schwarz, N., & Stone, A. A. (2004). A survey method for characterizing daily life experience: the day reconstruction method. Science, 306, 1776–1780. doi: 10.1126/science.1103572.
 
19.
Kettler, L. J., Sawyer, S. M., Winefield, H. R., & Greville, H. W. (2002). Determinants of adherence in adults with cystic fibrosis. An International Journal of Respiratory Medicine; Thorax, 57, 459–464. doi: 10.1136/thorax.57.5.459.
 
20.
Keyte, R., Beswick, L., Rayner, O., Carr, S. B., Bryon, M., & Medhurst, N. (2017). Self-reported motivators to treatment adherence in adults with cystic fibrosis in the UK. Journal of Cystic Fibrosis, 16, S62. doi: 10.1016/S1569-1993(17)30365-X.
 
21.
Kilbourne, A. M. (2005). Depression linked to inadequate medication adherence. Diabetic Microvascular Complications Today. Retrieved from http://www.diabeticmctoday.com....
 
22.
Latchford, G., Duff, A., Quinn, J., Conway, S., & Conner, M. (2009). Adherence to nebulised antibiotics in cystic fibrosis. Journal of Cystic Fibrosis, 75, 141–144. doi: 10.1016/j.pec.2008.08.027.
 
23.
Leventhal, H., Weinman, J., Leventhal, E. A., & Phillips, L. A. (2007). Health psychology: the search for pathways between behaviour and health. Annual Review of Psychology, 59, 1–29. doi: 10.1146/annurev.psych.59.103006.093643.
 
24.
MacCallum, R. C., Zhang, S., Preacher, K. J., & Rucker, D. D. (2002). On the practice of dichotomization of quantitative variables. Psychological Methods, 7, 19–40. doi: 10.1037//1082-989X.7.1.19.
 
25.
McNamara, P. S., McCormack, P., McDonald, A. J., Heaf, L., & Southern, K. W. (2009). Open adherence monitoring using routine data download from an adaptive aerosol delivery nebuliser in children with cystic fibrosis. Journal of Cystic Fibrosis, 8, 258–263. doi: 10.1016/j.jcf.2009.04.006.
 
26.
Modi, A. C., Lim, C. S., Yu, N., Geller, D., Wagner, M. H., & Quittner, A. L. (2006). A multi-method assessment of treatment adherence for children with cystic fibrosis. Journal of Cystic Fibrosis, 5, 177–185. doi: 10.1016/j.jcf.2006.03.002.
 
27.
Modi, A. C., & Quittner, A. L. (2006). Utilizing computerized phone diary procedures to assess health behaviours in family and social contexts. Child Health Care, 35, 29–45. doi: 10.1207/s15326888chc3501_4.
 
28.
O’Donohoe, R., & Fullen, B. M. (2014). Adherence of subjects with cystic fibrosis to their home program: a systematic review. Respiratory Care, 59, 1731–1746. doi: 10.4187/respcare.02990.
 
29.
Patterson, J. M., Wall, M., Berge, J., & Milla, C. (2008). Gender differences in treatment adherence among youth with cystic fibrosis: Development of a new questionnaire. Journal of Cystic Fibrosis, 7, 154–164. doi: 10.1016/j.jcf.2007.07.008.
 
30.
Quittner, A. L., & Espelage, D. L. (1999). Assessing complex family interactions using the daily phone diary. In A. C. Modi, C. S. Lim, N. Yu, D. Geller, M. H. Wagner, & A. L. Quittner (2006). A multi-method assessment of treatment adherence for children with cystic fibrosis. Journal of Cystic Fibrosis, 5, 177–185. doi: 10.1016/j.jcf.2006.03.002.
 
31.
Quittner, A. L., Modi, A. C., Lemanek, K. L., Ievers-Landis, C. E., & Rapoff, M. A. (2008). Evidence-based assessment of adherence to medical treatments in pediatric psychology. Journal of Pediatric Psychology, 33, 916–936. doi: 10.1093/jpepsy/jsm064.
 
32.
Quittner, A. L., Zhang, J., Narynchenko, M., Chopra, P. A., Signorovitch, J., Yushkina, Y., & Riekert, K. A. (2014). Pulmonary medication adherence and health-care use in cystic fibrosis. Chest, 146, 142–151. doi: 10.1378/chest.13-1926.
 
33.
Rucker, D. D., McShane, B. B., & Preacher, K. J. (2015). A researcher’s guide to regression, discretization and median splits of continuous variables. Journal of Consumer Psychology, 25, 666–678. doi: 10.1016/j.jcps.2015.04.004.
 
34.
Scanfeld, D., Scanfeld, V., & Larson, E. L. (2010). Dissemination of health information through social networks: Twitter and antibiotics. American Journal of Infection Control, 38, 182–188. doi: 10.1016/j.ajic.2009.11.004.
 
35.
Snaith, R. P., & Zigmond, A. S. (2012). The hospital anxiety and depression scale manual. London, UK: GL Education Group.
 
36.
Sundbom, L. T., & Bingefors, K. (2013). The influence of symptoms of anxiety and depression on medication non adherence and its causes: a population based survey of prescription drug users in sweden. Patient Preference and Adherence, 7, 805–811. doi: 10.2147/PPA.S50055.
 
37.
Taylor-Robinson, D. C., Smyth, R., Diggle, P. J., & Whitehead, M. (2013). A longitudinal study of the impact of social deprivation and disease severity on employment status in the UK cystic fibrosis population. PloS One, 8, 1–8. doi: 10.1371/journal.pone.0073322.
 
38.
The Cystic Fibrosis Trust. (2016). UK CF Registry; Reporting and Resources. Retrieved from https://cms.cysticfibrosis.org...#.
 
39.
Tierney, S. (2012). Body image and cystic fibrosis: a critical review. Body Image, 9, 12–19. doi: 10.1016/j.bodyim.2011.09.001.
 
40.
Withers, A. L. (2012). Management issues for adolescents with cystic fibrosis. Pulmonary Medicine, 1, 1–10. doi: 10.1155/2012/134132.
 
41.
Yates, L., Bond, L., Dixon, M., Drew, S., Ferguson, P., Hay, T., …White, J. (2010). Identity, social connection and education for young people living with chronic illness. Keeping Connected, Young People, Identity and Schooling. Retrieved from http://dro.deakin.edu.au/eserv....
 
42.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x.
 
Copyright: © Institute of Psychology, University of Gdansk This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
eISSN:2353-5571
ISSN:2353-4184
Journals System - logo
Scroll to top