2019-04-06

008_ Influence of Personality Traits on Medication Adherence

Research Question and Aims

State of the art: According to the World Health Organisation (WHO), medication adherence is defined as the extent to which a person's behavior - taking medication, following a diet, and / or executing lifestyle changes, corresponds with agreed recommendation from a healthcare provider (Osterberg and Blaschke, 2005). Medication adherence is an often neglected but crucial component for the success of a treatment regime. Approximately 50% of patients do not take their medication as prescribed (Brown and Bussell, 2011). Nonadherence can contribute to worsening or progress of the disease course, frequent hospitalization, emergency department visits and a substantial increase in healthcare costs (Brown and Bussell, 2011; Iuga and McGuire, 2014; Osterberg and Blaschke, 2005) Especially in chronic psychiatric diseases such as bipolar disorder, unipolar depression, schizophrenia and schizoaffective disorder the stabilization in the long-term is often dependent on a good cooperation between the patient and the health care provider and the treatment adherence (Beebe et al., 2016; Chakrabarti, 2016; Greene et al., 2018). The medication adherence in the PsyCourse cohort is measured by a medication adherence questionnaire. The Big Five Inventory (BFI-10) is an abbreviated questionnaire to assess personality traits according to the five main personality traits such as openness to experience, conscientiousness, extraversion, neuroticism and agreeableness (Rammstedt and John, 2007). Comorbid personality disorders or pronounced personality characteristics can complicate the interpersonal relationship, behavior, and perhaps cooperation in treatment (Bielanska et al., 2016). Additional factors, such as social support, course of the illness and current medication and adverse events can shape adherence (DiMatteo, 2004).
Objective: We would like to investigate whether patients' personality traits influence their medication adherence at the time point of study enrolment. The influence of additional factors such as social support, duration of illness and adverse effects of treatment on the medication adherence will be checked as secondary outcome parameters.

Analytic Plan

Hypothesis 1: Different personality traits influence medication adherence.
Hypothesis 2: Social support, course of illness and current medication and adverse events influence medication adherence.

Participants:
Data will be used from participants (patients, not controls) who have completed the adherence questionnaire and BFI-10 questionnaire at timepoint 1 based on PsyCourse 3.0 or later.

Phenotype:
See attached file "Data request form"

Analytic methods
- The analyses will be performed in cross-diagnostic and diagnostic subgroups: schizophrenia, schizoaffective disorder, bipolar disorder, unipolar depression
- In the diagnostic subgroups the association of medication adherence, personality traits, social support, course of illness, current medication and adverse events will be studied. Furthermore, confounding factors such as substance abuse and crystallized intelligence (MWTB) will be considered in the model. - We will perform a logistic regression analysis to identify phenotypic characteristics which explain the adherence behavior. Imputation will be required.

Resources neededDemographic data Identification code v1_id Clinical/control status v1_stat Recruitment center v1_center Interviewer v1_tstlt Date of interview v1_interv_date Gender: v1_sex Age (at first interview, years) v1_ageBL Year of birth v1_yob Marital status v1_marital_stat Partnership status v1_partner Children v1_no_bio_chld Siblings v1_brothers v1_sisters v1_hlf_brthrs v1_hlf_sstrs Living alone v1_liv_alone High-school level education v1_school Professional education v1_prof_dgr Educational status scale v1_ed_status Currently paid employment v1_curr_paid_empl Disability pension due psychological/psychiatric illness v1_disabl_pens Employed in workshop for handicapped persons v1_spec_emp Months of work absence (last 5 years) v1_wrk_abs_pst_5_yrs Currently impaired by psychological/psychiatric symptoms in exercising profession v1_cur_work_restr Country of birth v1_cntr_brth Current psychiatric treatment v1_cur_psy_trm Psychiatric history Ever treated as outpatient v1_outpat_psy_trm Age at first ambulatory treatment v1_age_1st_out_trm Ever treated as inpatient or daypatient v1_daypat_inpat_trm Age at first inpatient treatment v1_age_1st_inpat_trm

v1_dur_illness
v1_1st_ep
v1_tms_daypat_outpat_trm
v1_cat_daypat_outpat_trm
v1_scid_evr_suic_ide
v1_suic_attmpt
v1_scid_no_suic_attmpt

Medication
v1_Antidepressants
v1_Antipsychotics
v1_Mood_Stabilizers
v1_Tranquilizers
v1_Other_psychiatric
v1_adv

Substance abuse
v1_ever_smkd
v1_age_smk
v1_no_cig
v1_alc_pst12_mths
v1_alc_5orm
v1_lftm_alc_dep
v1_evr_ill_drg

CLINICAL SAMPLE:
get ALL drugs for which more than one category was ticked

CONTROL SAMPLE:
get ALL drugs for which more than one category was ticked

Diagnosis
v1_scid_dsm_dx
v1_scid_dsm_dx_cat
v1_cgi_s
v1_gaf
v4_opcrit

Cognition
v1_nrpsy_mwtb

Adherence
v1_med_pst_wk
v1_med_pst_sx_mths

Quality of Life
v1_whoqol_dom_glob
v1_whoqol_dom_phys
v1_whoqol_dom_psy
v1_whoqol_dom_soc
v1_whoqol_dom_env

Personality
v1_big_five_itm1
v1_big_five_itm2
v1_big_five_itm3
v1_big_five_itm4
v1_big_five_itm5
v1_big_five_itm6
v1_big_five_itm7
v1_big_five_itm8
v1_big_five_itm9
v1_big_five_itm10
v1_big_five_extra
v1_big_five_neuro
v1_big_five_openn
v1_big_five_consc
v1_big_five_agree