title: Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the Necessity-Concerns Framework.
abstract: OBJECTIVE
  The objective of this study was to explore beliefs about medicines, using the Necessity-Concerns Framework, of patients who report adherence, unintentional nonadherence, and intentional nonadherence.
  
  
  METHODS
  This study performed a cross-sectional survey of patients starting a new medication for a chronic condition. Self-reported adherence was assessed via telephone interview. The Necessity-Concerns Framework was operationalized using the Beliefs About Medicines Questionnaire, which assesses beliefs about the necessity of and concerns with taking medications.
  
  
  RESULTS
  Intentional nonadherers, compared to adherers, had lower perceptions of the necessity of their new medication and higher levels of concerns about taking it. Conversely, unintentional nonadherers were not significantly different from adherers. Intentional nonadherers were more likely to rate their concerns as high relative to their need for treatment than both adherers and unintentional nonadherers.
  
  
  CONCLUSIONS
  When patients start a new medication for a chronic condition, intentional nonadherers hold beliefs significantly different from those of adherers and unintentional nonadherers. These findings have implications for practice in helping clinicians to reduce this type of nonadherence.
authors.affiliation: Department of Practice and Policy, The School of Pharmacy, University of London, London, United Kingdom. sarah.clifford@pharmacy.ac.uk <sarah.clifford@pharmacy.ac.uk>
authors.forename: Sarah
authors.initials: S
authors.lastname: Clifford
authors.forename: Nick
authors.initials: N
authors.lastname: Barber
authors.forename: Rob
authors.initials: R
authors.lastname: Horne
mesh_terms: D000368:Aged; D001294:Attitude to Health; D002908:Chronic Disease / Q000188:drug therapy* / Q000523:psychology; D003469:Culture; D004739:England; D005260:Female; D006306:Health Surveys; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology*