Evidence map›Paper›PMID 27933471›Full record

ArticleDigestive diseases and sciences2017

Factors Associated with Medication Non-adherence in Patients with End-Stage Liver Disease.

Selena Z Kuo, Marta Haftek, Jennifer C Lai

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PubMed Full text at PMC Publisher
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Article in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  17. Reply.Hepatology communications · 2019
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  19. Patient Compliance: Fact or Fiction?Innovations in pharmacy · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Selena Z KuoDivision of Gastroenterology/Hepatology, Department of Medicine, University of California, San Francisco, 513 Parnassus Ave, Med Sci, San Francisco, CA, 94143, USA.
Marta HaftekDivision of Gastroenterology/Hepatology, Department of Medicine, University of California, San Francisco, 513 Parnassus Ave, Med Sci, San Francisco, CA, 94143, USA.
Jennifer C LaiDivision of Gastroenterology/Hepatology, Department of Medicine, University of California, San Francisco, 513 Parnassus Ave, Med Sci, San Francisco, CA, 94143, USA. Jennifer.lai@ucsf.edu.

Funding

UCSF Liver Core CenterP30DK026743 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Holger Willenbring · 1986 to 2026
$30.7M
Frailty and Functional Status in Older Liver Transplant PatientsK23AG048337 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LAI, JENNIFER C. · 2014 to 2018
$911k
Global Functional Status in the Older Liver Transplant CandidateR03AG045072 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LAI, JENNIFER C. · 2013 to 2014
$158k
NIA NIH HHS K23 AG048337NIA NIH HHS R03 AG045072NIDDK NIH HHS P30 DK026743
6 · The paper itself

Abstract

backgroundLow medication adherence is known to contribute to worse health outcomes in the general population.

aimWe aimed to evaluate the medication regimen and determine the adherence levels among patients with end-stage liver disease.

methodsWe measured adherence in patients awaiting liver transplantation at a single center using the 8-item Morisky Medication Adherence Scale (MMAS-8), with a score <8 classified as low adherence. Medication regimen complexity was assessed using the Medication Regimen Complexity Index (MRCI) tool. Factors associated with low adherence were identified by logistic regression.

resultsOf 181 patients, 33% were female, median age was 62, and model for end-stage liver disease (MELD) score was 13. The median (IQR) number of medications was 10 (7-13), and the MRCI was 19 (13-27). In total, 54 (30%) were high adherers, and 127 (70%) were low adherers. In total, 42% reported sometimes forgetting to take their medication and 22% reported intermittent adherence within the past 2 weeks. The most common reasons for low adherence were: forgetfulness (27%) and side effects (14%). Compared to high adherence, low adherence was associated with higher number of medications, medication complexity, and diabetes, but lower rates of hepatocellular carcinoma and self-perceived health. In univariable logistic regression, total medication number (OR 1.08), MRCI (OR 1.04), diabetes (OR 2.38), HCC (OR 0.38), and lower self-perceived health (OR 1.37), were statistically significant factors associated with non-adherence. In multivariate analysis, only medication number without supplements (OR 1.14) remained significantly associated with medication non-adherence.

conclusionA majority of patients awaiting liver transplantation demonstrated low medication adherence. Total number of medications and regimen complexity were strong correlates of low adherence. Our data underscores the need for chronic liver disease management programs to improve medication adherence in this vulnerable population.

Indexed as

Drug MonitoringHealth StatusAgedCarcinoma, HepatocellularDiabetes MellitusEnd Stage Liver DiseaseFemaleHumansLiver NeoplasmsLogistic ModelsMaleMiddle AgedMultivariate AnalysisPolypharmacyRisk FactorsSeverity of Illness IndexEnd-stage liver diseaseLiver transplantationMedication adherenceMedication complexity regimen indexMMAS-8

Identifiers

PMID27933471
PMCPMC5263169

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.