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The utility of the Necessity—Concerns Framework in explaining treatment non-adherence in four chronic illness groups in Italy

Centro Studi e Ricerche in Psichiatria, Piazza del Donatore di Sangue 3, 10154 Torino, Italy

Jane Clatworthy

Centre for Behavioural Medicine, The School of Pharmacy, University of London, Mezzanine Floor, BMA House, Tavistock Square, London WC1H 9JP, UK

Elisabetta Torchio

Centro Studi e Ricerche in Psichiatria, Piazza del Donatore di Sangue 3, 10154 Torino, Italy

Piergiorgio Argentero

Department of Psychology, University of Pavia, Piazza Botta 6, I-27100 Pavia, Italy

Carmine Munizza

Centro Studi e Ricerche in Psichiatria, Piazza del Donatore di Sangue 3, 10154 Torino, Italy

Rob Horne

Centre for Behavioural Medicine, The School of Pharmacy, University of London, Mezzanine Floor, BMA House, Tavistock Square, London WC1H 9JP, UK, rob.horne{at}pharmacy.ac.uk

Objective: To translate the Beliefs about Medicines Questionnaire (BMQ) into Italian and explore the utility of the Necessity—Concerns Framework in explaining treatment non-adherence in four chronic illness groups in Italy.

Methods: 449 patients with chronic illness (depression, asthma, diabetes and cardiac disease) were approached at outpatient clinics in Turin and asked to complete Italian translations of the BMQ and the Medication Adherence Report Scale.

Results: 427 patients consented to participate in the study. The BMQ demonstrated good internal consistency, with Cronbach's alphas of 0.78 (Necessity subscale) and 0.72 (Concerns subscale). Participants were divided into four attitudinal groups based on their responses to the BMQ: 59% Accepting (high Necessity, low Concerns), 29% ambivalent (high Necessity, high Concerns), 8% Indifferent (low Necessity, low Concerns) and 4% Skeptical (low Necessity, high Concerns). Those in the Accepting group reported the highest adherence to medication and those in the Skeptical group the lowest (p50.01).

Discussion: The BMQ has been successfully translated and validated in Italian. This study provides support for the Necessity—Concerns Framework in explaining medication non-adherence in chronic illness. Interventions that address low perceived need for treatment and concerns about potential adverse effects of treatment are likely to facilitate optimal use of medicines.

Key Words: Adherence • Attitudes • Attitudinal analysis • Beliefs about Medicines Questionnaire • Necessity— Concerns Framework

Chronic Illness, Vol. 5, No. 2, 129-133 (2009)
DOI: 10.1177/1742395309102888


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