Beliefs About Medications as a Predictor of Treatment Adherence in Women with Urinary Incontinence

Objective: To investigate the association between beliefs about medications and primary adherence in women prescribed anticholinergic medications for urgency urinary incontinence (UUI). Methods: We enrolled 160 women with UUI who were prescribed anticholinergic medications between 2009 and 2010. Validated questionnaires were administered to measure the diagnosis of UUI, its impact on quality of life, and beliefs about medications. Primary adherence, filling of a prescription within 30 days, was measured through pharmacy records. The association between healthcare beliefs and primary adherence was measured using multivariable analysis. Results: The incidence of primary adherence to anticholinergic medication was 73%. Of the women, 5% reported belief in the general harm of medicines, 31% reported belief in the general overuse of medicines, and 90% reported belief in the general benefit of medicines. Responses to the Beliefs about Medicines Questionnaire (BMQ) had good internal consistency in women with UUI (Cronbach's alpha 0.59-0.75). On univariable analysis, belief in the general overuse of medicines (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.23-0.99) and belief in the general harm of medicines (OR 0.11, 95% CI 0.02-0.57) were significant negative predictors of primary adherence to anticholinergic medications. A significant relationship between the impact of urinary symptoms on quality of life and primary adherence was not noted (OR 1.02, 95% CI 0.86-1.22). On multivariable analysis, belief in the general overuse of medicines remained a significant negative predictor of primary adherence (OR 0.35, 95% CI 0.16-0.79). Conclusions: Women with UUI who believe that medicines in general are overused are less likely to fill their prescriptions for anticholinergic medications.