When medical knowledge is not enough: medication adherence and self-treatment among physicians with chronic illness...

Medication adherence in chronic illness is influenced by behavioral, psychological, and contextual factors. Whether physicians-despite high medical literacy-demonstrate superior adherence compared with non-physician patients remains unclear. This study compared medication adherence between physicians with chronic illness and matched non-physician controls and examined psychological and behavioral correlates, including self-treatment practices.

A cross-sectional comparative study was conducted among 250 physicians and 250 age-, sex-, and disease-category-matched non-physician adults receiving long-term pharmacotherapy at university outpatient clinics in Upper Egypt. Self-reported adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) as the primary adherence measure. Self-treatment behavior, depressive symptoms, anxiety, and burnout were evaluated using validated instruments. In a consenting subset, objective adherence was estimated using pharmacy refill data (proportion of days covered [PDC]) and documented pill-count records. Multivariable logistic regression models were used to examine factors associated with adequate adherence.

The prevalence of adequate self-reported adherence did not differ significantly between physicians and controls (28.4% vs. 31.2%, p = 0.557). Among participants who consented to pharmacy linkage (36% physicians; 43% controls), median PDC and the proportion achieving PDC ≥ 0.80 were comparable between groups. Agreement between self-reported and objective adherence was poor in both cohorts. In adjusted analyses, physician status was not independently associated with adequate adherence. A higher number of prescribed medications and greater engagement in self-treatment behaviors were independently associated with higher odds of adequate self-reported adherence.

Physicians with chronic illness demonstrated adherence patterns comparable to matched non-physician patients. Professional training and medical knowledge were not independently associated with better adherence. Behavioral engagement and treatment-related factors appeared more strongly associated with adherence than occupational status. The limited concordance between self-reported and objective adherence highlights the importance of multimethod assessment in adherence research.