An investigation into the factors affecting adherence to drug treatment in an adult cystic fibrosis population
P. Kelly, Department of Respiratory Medicine & Cystic Fibrosis, Belfast City HospitaL, UK

Aims: Adherence to therapy is an important issue in Cystic Fibrosis as non-adherence may have a negative effect on disease status and progression. The present study was undertaken to determine the influence of the following factors on adherence to drug treatment in adults with cystic fibrosis, knowledge of medication & disease state, perceived positive benefits from taking medication and problems associated with taking a particular drug.
Method: Data were collected using a questionaire and face-to-face interviews with cystic fibrosis adults at Belfast City Hospital. Specific questions were asked to ascertain patient's knowledge of  disease and their medication. Perceived positive benefits of medicines was assessed using the Beliefs about Medicines Questionaire (BMQ) . Self-reported compliance was used to assess adherence to drug treatment. Patients were asked if they skipped doses, forget to take medication or run out of medication.
Results: 44 patients participated in the study. No correlation between compliance and patient knowledge of their medication or disease state was observed (p=0.678 and p=0.87 respectively). A higher BMQ score was found in adherent  patients with a mean of 41 compared to 37 in the non-compliant population (n=22, p=0.06). Scores ranged from 26 to 49 and the most frequent score was 37. There was a negative correlation between patients experiencing problems taking their medication (eg suffering side-effects) and adherence with these medicines (p=0.04).
Conclusions: This study suggests that a major factor determining compliance is patients perceived benefits of medication. Increased knowledge about disease state and medication is not related to better compliance. If a patient experiences problems with medicines (eg experiences side-effects) it has a negative effect on compliance.
Reference
1. Horne, R. Weinman, J, Hankins, M. (1999) The Beliefs about Medicines Questionaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology and Health 14, 1-24.

Gender and interpersonal relationships in cystic fibrosis: Do men and women differ in their self-ratings on relationship issues?
L.Gee, Faculty of Health, University of Central Lancashire,Preston

It has been reported that there are differences in clinical outcome for males and females with cystic fibrosis (CF) and related factors regarding disease status that may affect relationship issues. The present study aims to examine relationship difficulties in men and women with CF. This study utilises four items from the Cystic Fibrosis Quality of Life Questionnaire (CFQoL)* which ask respondents to self rate the following four statements: (1) my CF makes it difficult for me to establish intimate relationships, (2) my CF makes it difficult for me to maintain intimate relationships, (3) I find that my CF interferes with me having a satisfactory sex life, (4) it concerns me that I may not be able to have any/have more children. 223 adolescents and adults with CF completed the four items (102 men and 121 women). Differences between men and women were analysed using independent groups t-tests. No differences were found for age or FEV1. A significant difference was found for BMI with females having a lower BMI (p= .04). Significant differences were found for statements regarding establishing and maintaining intimate relationships (p=. 027 and p=. 042) with males demonstrating more difficulties. There were no differences between men and women for items regarding difficulties with sex life or concerns about having children. However, 30% of men and 26% of women reported difficulties with their sex life and 71% of men and 73% of women expressed concerns about their ability to have children. In conclusion, issues surrounding intimate relationships and reproduction are of concern to both men and women with CF. Men with CF are significantly more likely to be concerned about initiating and maintaining intimate relationships. It is therefore imperative that patients are offered support with disease related issues that impact on relationship issues, including optimising their ability to reproduce.
*for copies of the CFQoL and scoring equations contact J Abbott (e-mail jabbott@uclan.ac.uk).