• David Gillespie, Daniel Farewell, Lucy Brookes-Howell, Christopher C Butler, Samuel Coenen, Nick A Francis, Paul Little, Beth Stuart, Theo Verheij, and Kerenza Hood.
• Centre for Trials Research, College of Biomedical & Life Sciences.
• Patient Prefer Adher. 2017 Jan 1; 11: 561569561-569.

AimTo investigate the determinants of adherence to amoxicillin in patients with acute lower respiratory tract infection.Materials And MethodsThree European data sets were used. Adherence data were collected using self-reported diaries. Candidate determinants included factors relating to patient, condition, therapy, health care system/provider, and the study in which the patient participated. Logistic and Cox regression models were used to investigate the determinants of initiation, implementation, and discontinuation of amoxicillin.ResultsAlthough initiation differed across samples, implementation and discontinuation were similar. Determinants of initiation were days waited before consulting, duration of prescription, and being in a country where a doctor-issued sick certificate is required for being off work for <7 days. Implementation was higher for older participants or those with abnormal auscultation. Implementation was lower for those prescribed longer courses of amoxicillin (≥8 days). Time from initiation to discontinuation was longer for longer prescriptions and shorter for those from countries where single-handed practices were widespread.ConclusionNonadherence to amoxicillin was largely driven by noninitiation. Differing sets of determinants were found for initiation, implementation, and discontinuation. There is a need to further understand the reasons for these determinants, the impact of poor adherence to antibiotics on outcomes, and to develop interventions to improve antibiotic use when prescribed.

4 keywords...

hide…