Effect of necessity-concern framework and polypharmacy on treatment adherence in psychiatric patients. Comparing an Argentinian with a Spanish sample

Carlos De las Cuevas, Alejandro G. Villasante-Tezanos, Mariano Motuca, Jose de Leon

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: We aimed to replicate a prior Spanish study of medication adherence where logistic regression models provided highly significant odds ratios (ORs) for three continuous scores: necessity, concern and the necessity-concern differential, and a dichotomous variable: skeptical attitude. Adherence ORs in the necessity-concern framework were very strong in patients taking five or six medications. Methods: The sample comprised consecutive adult psychiatric outpatients in Mendoza, Argentina. The necessity-concerns framework was assessed using a subscale of the Beliefs about Medicines Questionnaire. Adherence (yes/no) to prescribed psychiatric medications was assessed by the Sidorkiewicz adherence tool. Results: When compared with the Spanish sample, the Argentinian group (508 patients with 875 medications) was characterized by: (1) significantly stronger adherence ORs with the necessity-concern framework, (2) significantly lower number of medications per patient and percentage of patients with marked psychiatric polypharmacy (≥4 medications), (3) though a higher number of medications still was significantly associated with poor adherence. Conclusions: The Argentinian sample replicated the previous finding that patient beliefs regarding necessity and concern were associated with poor adherence to prescribed medications. Polypharmacy had an additive role decreasing adherence in both samples. In both samples, when prescribed ≥4 psychiatric medications, patients reported adherence to only two-third of the medications.

Original languageEnglish
Article numbere2776
JournalHuman Psychopharmacology
Issue number4
StatePublished - Jul 2021

Bibliographical note

Funding Information:
Funding for this study was provided exclusively by internal university support. The authors acknowledge Lorraine Maw, M.A., from the University of Kentucky Mental Health Research Center at Eastern State Hospital, who helped in editing the article. The authors are grateful to the reviewers who helped them improve the final version of the article.

Publisher Copyright:
© 2021 John Wiley & Sons Ltd.


  • attitude to health
  • health behavior
  • medication adherence
  • patient acceptance of health care/drug effects
  • polypharmacy
  • psychopharmacology
  • treatment adherence and compliance

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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