Beyond Medication: A Cross-Sectional Study of How Sex Influences Overall Chronic Disease Adherence Behaviour Using the French Generic Adherence for Chronic Diseases Profile (GACID-P).

内容摘要

Adherence research has historically focused on medication-taking behaviors. While evidence suggests that males are generally more adherent to medication regimens than females, the influence of sex on overall adherence behaviors remains unclear. We explored how sex influences a multidimensional profile of adherence beyond medication using the Generic French Adherence in Chronic Diseases Profile (GACID-P). We conducted a cross-sectional study using data from the validation of the GACID-P. Participants were adults (>18 years) with chronic conditions attending specialist care across the Grand-Est region of France. The 25-item self-report GACID-P assesses four domains of adherence - Intention to comply with treatment, Forgetting to take medication, Healthy lifestyle, and Limitation of risk-related consumer habits - with scores ranging from 0 (worst) to 10 (best), except for forgetting, which is reverse scored. Analyses included sex-stratified comparisons, multivariable linear regression models, and multivariate analysis of variance to examine sex-based adherence patterns within and across domains. Among 397 participants (53% male; mean age: males 57.1 ± 10.7, females 59.3 ± 11.7), domain scores indicated generally good adherence. Within domains, males had higher scores than females for Intention to comply (9.18 ± 1.15 vs 8.96 ± 1.51), less Forgetting to take medication (1.35 ± 2.42 vs 1.82 ± 2.85), more Healthy lifestyle (6.92 ± 1.95 vs 6.61 ± 2.00), while females scored higher for Limitation of risk-related consumer habits (6.15 ± 2.14 vs 5.24 ± 2.14); however, none of these differences reached statistical significance. Across domains, a multivariate analysis suggested a sex effect (Wilks' Lambda = 0.84, F(4,73) = 3.58, p=0.010), driven primarily by differences in Forgetting to take medication where males reported less forgetting than females, when adherence patterns are considered jointly across domains (F(1,76) = 10.39, p = 0.0019). Despite the absence of statistically significant sex-based differences within individual GACID-P domains, a multivariate analysis suggested potential differences when adherence behaviors were considered jointly. While these findings should be interpreted cautiously, they support consideration of a sex-based lens to better understand adherence. We did this study to better understand whether males and females differ in how they follow their treatment plans for long-term health conditions. Most previous research has focused only on how well people take their medications. These earlier studies suggest that males may take their medicines more regularly than females. However, following a treatment plan involves more than medication alone, and much less is known about whether males and females differ in other important parts of following treatment plans. We wanted to look at the bigger picture. We used a survey that examines several different areas of treatment behavior. These include taking medications as prescribed, remembering to take medications on time, making healthy lifestyle choices, and avoiding risky habits. By looking across all of these areas, we hoped to get a fuller understanding of how people follow treatment plans. When we compared males and females, we did not find clear differences in any single area on its own. There was a general pattern where males tended to report slightly better behaviours in some areas (such as taking medications as directed, remembering doses and having healthier lifestyle habits), while females tended to report slightly higher avoidance of risky habits, but these differences were small and not strong enough to draw firm conclusions.However, when we looked at all of the treatment behaviors together, one finding stood out: males were less likely to forget their medications compared to females. This may suggest that any influence of sex on treatment habits is complex and may not be apparent within individual areas alone.