Abstract
According to the Necessity-Concerns Framework, beliefs about medication necessity and concerns are two core themes from diverse patient medication beliefs across chronic illnesses that may directly influence adherence. Past work has supported associations of necessity and concerns to adherence in the chronic disease literature and in HIV research. However, there has not been a focused review of the literature on associations of necessity and concerns to HIV medication adherence, nor on what variables may influence these associations. This systematic review synthesized findings from 26 studies regarding associations of necessity and concerns to HIV medication adherence. Both beliefs showed small, clinically significant effects on adherence. A subset of studies identified perceptions of healthcare providers as determinants of necessity and concerns beliefs with indirect effects on adherence. Overall, necessity and concerns demonstrated clinically significant associations to adherence among people with HIV.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Batchelder, A. W., Gonzalez, J. S., & Berg, K. M. (2014). Differential medication nonadherence and illness beliefs in co-morbid HIV and type 2 diabetes. Journal of Behavioral Medicine,37(2), 266–275. https://doi.org/10.1007/s10865-012-9486-1
Bezabhe, W. M., Chalmers, L., Bereznicki, L. R., Gee, P., & Peterson, G. M. (2016a). Antiretroviral adherence and treatment outcomes among adult Ethiopian patients. AIDS Care,28(8), 1018–1022. https://doi.org/10.1080/09540121.2016.1139039
Bezabhe, W. M., Chalmers, L., Bereznicki, L. R., & Peterson, G. M. (2016b). Adherence to antiretroviral therapy and virologic failure: A meta-analysis. Medicine (Baltimore),95, e3361. https://doi.org/10.1097/MD.0000000000003361
Bosworth, H. B. (2006). Medication treatment adherence. In H. B. Bosworth, E. Z. Oddone, & M. Weinberger (Eds.), Patient treatment adherence: Concepts, interventions, and measurement (pp. 147–194). Mahwah, NJ: Lawrence Erlbaum Associates.
Brittain, K., Remien, R. H., Mellins, C. A., Phillips, T. K., Zerbe, A., Abrams, E. J., et al. (2018). Determinants of suboptimal adherence and elevated HIV viral load in pregnant women already on antiretroviral therapy when entering antenatal care in cape town, south africa. AIDS Care. https://doi.org/10.1080/09540121.2018.1503637
Brown, J. L., Littlewood, R. A., & Vanable, P. A. (2013). Social-cognitive correlates of antiretroviral therapy adherence among HIV-infected individuals receiving infectious disease care in a medium-sized northeastern US city. AIDS Care,25(9), 1149–1158. https://doi.org/10.1080/09540121.2012.752566
Centers for Disease Control and Prevention. (2016). HIV in the United States: At a glance. Retrieved December 7, 2016, from https://www.cdc.gov/hiv/statistics/overview/ataglance.html
Chesney, M. A. (2006). The elusive gold standard. Future perspectives for HIV adherence assessment and intervention. Journal of Acquired Immune Deficiency Syndromes,43, S149–S155. https://doi.org/10.1097/01.qai.0000243112.91293.26
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum Associates.
Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., et al. (2011). Prevention of HIV-1 infection with early antiretroviral therapy. The New England Journal of Medicine,365(6), 493–505. https://doi.org/10.1056/NEJMoa1105243
Cooper, V., Horne, R., Gellaitry, G., Vrijens, B., Lange, A. C., Fisher, M., et al. (2010). The impact of once-nightly versus twice-daily dosing and baseline beliefs about HAART on adherence to efavirenz-based HAART over 48 weeks: The NOCTE study. Journal of Acquired Immune Deficiency Syndromes,53(3), 369–377. https://doi.org/10.1097/QAI.0b013e3181ccb762
Cooper, V., Moyle, G. J., Fisher, M., Reilly, G., Ewan, J., Liu, H. C., et al. (2011). Beliefs about antiretroviral therapy, treatment adherence and quality of life in a 48-week randomised study of continuation of zidovudine/lamivudine or switch to tenofovir DF/emtricitabine, each with efavirenz. AIDS Care,23(6), 705–713. https://doi.org/10.1080/09540121.2010.534433
de Boer-van der Kolk, I. M., Sprangers, M. A. G., van der Ende, M., Schreij, G., de Wolf, F., & Nieuwkerk, P. T. (2008). Lower perceived necessity of HAART predicts lower treatment adherence and worse virological response in the ATHENA cohort. Journal of Acquired Immune Deficiency Syndromes,49(4), 460–462. https://doi.org/10.1097/QAI.0b013e318186eefe
Dillon, P., Phillips, L. A., Gallagher, P., Smith, S. M., Stewart, D., & Cousins, G. (2018). Assessing the multidimensional relationship between medication beliefs and adherence in older adults with hypertension using polynomial regression. Annals of Behavioral Medicine,52, 146–156. https://doi.org/10.1093/abm/kax016
Edwards, J. R. (2001). Ten difference score myths. Organizational Research Methods,4, 265–287. https://doi.org/10.1177/109442810143005
Edwards, J. R. (2002). Alternatives to difference scores: Polynomial regression analysis and response surface methodology. In F. Drasgow & N. W. Schmitt (Eds.), Advances in measurement and data analysis (pp. 350–400). San Francisco, CA: Jossey-Bass.
Fall, E., Gauchet, A., Izaute, M., Horne, R., & Chakroun, N. (2014). Validation of the French version of the Beliefs about Medicines Questionnaire (BMQ) among diabetes and HIV patients. European Review of Applied Psychology / Revue Européenne de Psychologie Appliquée,64, 335–343. https://doi.org/10.1016/j.erap.2014.08.005
Garrison, L. E., & Haberer, J. E. (2017). Technological methods to measure adherence to antiretroviral therapy and preexposure prophylaxis. Current Opinion in HIV and AIDS,12, 467–474. https://doi.org/10.1097/COH.0000000000000393
Gauchet, A., Tarquinio, C., & Fischer, G. (2007). Psychosocial predictors of medication adherence among persons living with HIV. International Journal of Behavioral Medicine,14, 141–150. https://doi.org/10.1007/BF03000185
Gonzalez, J. S., Penedo, F. J., Llabre, M. M., Duran, R. E., Antoni, M. H., Schneiderman, N., et al. (2007). Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence. Annals of Behavioral Medicine,34, 46–55. https://doi.org/10.1080/08836610701495565
Gunthard, H. F., Saag, M. S., Benson, C. A., del Rio, C., Eron, J. J., Gallant, J. E., et al. (2016). Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2016 recommendations of the international antiviral society-USA panel. Journal of the American Medical Association,316, 191–210. https://doi.org/10.1001/jama.2016.8900
Horne, R. (1997). Representations of medication and treatment: Advances in theory and measurement. In K. J. Petrie & J. A. Weinman (Eds.), Perceptions of health and illness: Current research and applications (pp. 155–188). Amsterdam: Harwood Academic.
Horne, R. (2003). Treatment perceptions and self-regulation. In L. D. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 138–153). London: Routledge.
Horne, R., Buick, D., Fisher, M., Leake, H., Cooper, V., & Weinman, J. (2004). Doubts about necessity and concerns about adverse effects: Identifying the types of beliefs that are associated with non-adherence to HAART. International Journal of STD and AIDS,15, 38–44. https://doi.org/10.1258/095646204322637245
Horne, R., Chapman, S. C., Parham, R., Freemantle, N., Forbes, A., & Cooper, V. (2013). Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: A meta-analytic review of the necessity-concerns framework. PLoS ONE,8, 1–24. https://doi.org/10.1371/journal.pone.0080633
Horne, R., Cooper, V., Gellaitry, G., Date, H. L., & Fisher, M. (2007). Patients’ perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: The utility of the necessity-concerns framework. Journal of Acquired Immune Deficiency Syndromes,45, 334–341.
Horne, R., Weinman, J., & Hankins, M. (1999). The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology & Health,14, 1–24. https://doi.org/10.1080/08870449908407311
Johnson, M. O., Dilworth, S. E., Taylor, J. M., Darbes, L. A., Comfort, M. L., & Neilands, T. B. (2012). Primary relationships, HIV treatment adherence, and virologic control. AIDS and Behavior,16, 1511–1521. https://doi.org/10.1007/s10461-011-0021-0
Joint United Nations Programme on HIV/AIDS. (2017). Fact sheet July 2017. Retrieved September 5, 2017, from http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf
Kalichman, S. C., Eaton, L., Kalichman, M. O., & Cherry, C. (2015a). Medication beliefs mediate the association between medical mistrust and antiretroviral adherence among African Americans living with HIV/AIDS. Journal of Health Psychology. https://doi.org/10.1177/1359105315600239
Kalichman, S. C., Eaton, L., Kalichman, M. O., Grebler, T., Merely, C., & Welles, B. (2016a). Race-based medical mistrust, medication beliefs and HIV treatment adherence: Test of a mediation model in people living with HIV/AIDS. Journal of Behavioral Medicine,39, 1056–1064. https://doi.org/10.1007/s10865-016-9767-1
Kalichman, S. C., Kalichman, M. O., & Cherry, C. (2016b). Medication beliefs and structural barriers to treatment adherence among people living with HIV infection. Psychology & Health,31, 383–395. https://doi.org/10.1080/08870446.2015.1111371
Kalichman, S. C., Pellowski, J., Kegler, C., Cherry, C., & Kalichman, M. O. (2015b). Medication adherence in people dually treated for HIV infection and mental health conditions: Test of the medications beliefs framework. Journal of Behavioral Medicine,38, 632–641. https://doi.org/10.1007/s10865-015-9633-6
Kalichman, S. C., Washington, C., Grebler, T., Hoyt, G., Welles, B., Kegler, C., et al. (2015c). Medication adherence and health outcomes of people living with HIV who are food insecure and prescribed antiretrovirals that should be taken with food. Infectious Diseases and Therapy,4, 79–91. https://doi.org/10.1007/s40121-015-0057-y
Kamal, S., Bugnon, O., Cavassini, M., & Schneider, M. P. (2018). HIV-infected patients’ beliefs about their chronic co-treatments in comparison with their combined antiretroviral therapy. HIV Medicine,19, 49–58. https://doi.org/10.1111/hiv.12542
Kreys, E. (2016). Measurements of medication adherence: In search of a gold standard. Journal Of Clinical Pathways,2, 43–47.
Lam, W. Y., & Fresco, P. (2015). Medication adherence measures: An overview. BioMed Research International,2015, 1–12. https://doi.org/10.1155/2015/217047
Langebeek, N., Gisolf, E. H., Reiss, P., Vervoort, S. C., Hafsteinsdottir, T. B., Richter, C., et al. (2014). Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: A meta-analysis. BMC Medicine,12, 142. https://doi.org/10.1186/PREACCEPT-1453408941291432
Leventhal, H., Diefenbach, M., & Leventhal, E. (1992). Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions. Cognitive Therapy and Research,16, 143–163.
Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. In S. Rachman (Ed.), Medical psychology (pp. 7–30). New York, NY: Pergamon.
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P., et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Medicine,6, e1000100. https://doi.org/10.1371/journal.pmed.1000100
Littlewood, R. A., & Vanable, P. A. (2014). The relationship between CAM use and adherence to antiretroviral therapies among persons living with HIV. Health Psychology,33, 660–667. https://doi.org/10.1037/a0033519
Liu, H., Golin, C. E., Miller, L. G., Hays, R. D., Beck, C. K., Sanandaji, S., et al. (2001). A comparison study of multiple measures of adherence to HIV protease inhibitors. Annals of Internal Medicine,134, 968–977.
Magadza, C., Radloff, S. E., & Srinivas, S. C. (2009). The effect of an educational intervention on patients’ knowledge about hypertension, beliefs about medicines, and adherence. Research in Social & Administrative Pharmacy,5, 363–375. https://doi.org/10.1016/j.sapharm.2009.01.004
Nachega, J. B., Marconi, V. C., van Zyl, G. U., Gardner, E. M., Preiser, W., Hong, S. Y., et al. (2011). HIV treatment adherence, drug resistance, virologic failure: Evolving concepts. Infectious Disorders: Drug Targets,11, 167–174.
Newcomb, M. E., Bedoya, C. A., Blashill, A. J., Lerner, J. A., O’Cleirigh, C., Pinkston, M. M., et al. (2015). Description and demonstration of cognitive behavioral therapy to enhance antiretroviral therapy adherence and treat depression in HIV-infected adults. Cognitive and Behavioral Practice,22, 430–438. https://doi.org/10.1016/j.cbpra.2014.02.001
O’Carroll, R. E., Chambers, J. A., Dennis, M., Sudlow, C., & Johnston, M. (2013). Improving adherence to medication in stroke survivors: A pilot randomised controlled trial. Annals of Behavioral Medicine,46, 358–368. https://doi.org/10.1007/s12160-013-9515-5
Ortego, C., Huedo-Medina, T. B., Llorca, J., Sevilla, L., Santos, P., Rodriguez, E., et al. (2011). Adherence to highly active antiretroviral therapy (HAART): A meta-analysis. AIDS and Behavior,15, 1381–1396. https://doi.org/10.1007/s10461-011-9942-x
Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., Squier, C., et al. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine,133, 21–30.
Pellowski, J. A., Kalichman, S. C., Kalichman, M. O., & Cherry, C. (2016). Alcohol-antiretroviral therapy interactive toxicity beliefs and daily medication adherence and alcohol use among people living with HIV. AIDS Care,28, 963–970. https://doi.org/10.1080/09540121.2016.1154134
Pellowski, J. A., Price, D. M., Allen, A. M., Eaton, L. A., & Kalichman, S. C. (2017). The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV. Psychology & Health,32, 1127–1139. https://doi.org/10.1080/08870446.2017.1324969
Perera, A. I., Thomas, M. G., Moore, J. O., Faasse, K., & Petrie, K. J. (2014). Effect of a smartphone application incorporating personalized health-related imagery on adherence to antiretroviral therapy: A randomized clinical trial. AIDS Patient Care and STDs,28, 579–586. https://doi.org/10.1089/apc.2014.0156
Peyre, M., Gauchet, A., Roustit, M., Leclercq, P., & Epaulard, O. (2016). Influence of the first consultation on adherence to antiretroviral therapy for HIV-infected patients. Open AIDS Journal,10, 182–189. https://doi.org/10.2174/1874613601610010182
Phillips, L. A., Diefenbach, M. A., Kronish, I. M., Negron, R. M., & Horowitz, C. R. (2014). The Necessity-Concerns Framework: A multidimensional theory benefits from multidimensional analysis. Annals of Behavioral Medicine,48, 7–16. https://doi.org/10.1007/s12160-013-9579-2
Rosenthal, J. A. (1996). Qualitative descriptors of strength of association and effect size. Journal of Social Service Research,21, 37–59. https://doi.org/10.1300/J079v21n04_02
Saberi, P., Johnson, M. O., McCulloch, C. E., Vittinghoff, E., & Neilands, T. B. (2011). Medication adherence: Tailoring the analysis to the data. AIDS and Behavior,15, 1447–1453. https://doi.org/10.1007/s10461-011-9951-9
Samji, H., Cescon, A., Hogg, R. S., Modur, S. P., Althoff, K. N., Buchacz, K., et al. (2013). Closing the gap: Increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS ONE,8, e81355. https://doi.org/10.1371/journal.pone.0081355
Sianturi, E. I., Perwitasari, D. A., Islam, M. A., & Taxis, K. (2019). The association between ethnicity, stigma, beliefs about medicines and adherence in people living with HIV in a rural area in Indonesia. BMC Public Health,19, 55. https://doi.org/10.1186/s12889-019-6392-2
Sumari-de Boer, I. M., Sprangers, M. A. G., Prins, J. M., & Nieuwkerk, P. T. (2012). HIV stigma and depressive symptoms are related to adherence and virological response to antiretroviral treatment among immigrant and indigenous HIV infected patients. AIDS and Behavior,16, 1681–1689. https://doi.org/10.1007/s10461-011-0112-y
Uuskula, A., Laisaar, K. T., Raag, M., Smidt, J., Semjonova, S., Kogan, J., et al. (2012). Antiretroviral therapy (ART) adherence and correlates to nonadherence among people on ART in Estonia. AIDS Care,24, 1470–1479. https://doi.org/10.1080/09540121.2012.672724
Weiss, J. J., Konstantinidis, I., Boueilh, A., Fierer, D. S., Gardenier, D., Barber, M. G., et al. (2016). Illness perceptions, medication beliefs, and adherence to antiretrovirals and medications for comorbidities in adults with HIV infection and hypertension or chronic kidney disease. Journal of Acquired Immune Deficiency Syndromes,73, 403–410. https://doi.org/10.1097/qai.0000000000001075
Wilson, D. B. (n.d.). Practical meta-analysis effect size calculator [online calculator]. Retrieved July 15, 2017, from https://www.campbellcollaboration.org/escalc/html/EffectSizeCalculator-Home.php
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Both authors declare that they have no conflict of interest.
Human and animal rights and informed consent
This article does not contain any studies with human participants or animals performed by any of the authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Mitzel, L.D., Vanable, P.A. Necessity and concerns beliefs and HIV medication adherence: a systematic review. J Behav Med 43, 1–15 (2020). https://doi.org/10.1007/s10865-019-00089-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-019-00089-2