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The necessity-concerns framework: a multidimensional theory benefits from multidimensional analysis.

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Medication adherence is complex, influenced by both patient concerns and necessity beliefs. Understanding these multidimensional factors is key for improving patient outcomes in stroke survivors.

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Area of Science:

  • Medical adherence research
  • Psychology of medication taking
  • Stroke patient care

Background:

  • Patient medication beliefs, including concerns and necessity, are known predictors of adherence.
  • Previous research often simplified these beliefs, limiting the understanding of their complex interplay.

Purpose of the Study:

  • To investigate the multidimensional relationship between medication-related concerns, necessity beliefs, and adherence in stroke survivors.
  • To utilize polynomial regression to analyze these complex interactions.

Main Methods:

  • Surveyed 600 stroke survivors on their medication concerns, necessity beliefs, and adherence.
  • Employed confirmatory and exploratory polynomial regression to model the data.

Main Results:

  • Adherence was highest with weak concerns and lowest with strong concerns/weak necessity beliefs, aligning with the necessity-concerns framework (NCF).
  • Ambivalent beliefs led to lower adherence compared to indifference, a finding missed by simpler difference-score models.

Conclusions:

  • Polynomial regression effectively captures the multidimensional nature of the NCF.
  • Clinicians and researchers should recognize that medication concerns and necessity beliefs are not simple opposites and influence adherence in nuanced ways.