Patients’ perspectives about their treatment in cardiovascular diseases and mental disorders (Preprint)

Abstract

Non-communicable diseases (NCDs) account for 71% of deaths worldwide. The World Health Organization has recently developed a global action plan to address the impact of NCDs, with a goal of reducing the number of premature NCD-related deaths to 25% by the year 2025. Appropriate therapeutic adherence is critical for effective disease management; however, approximately 30-50% of patients with an NCD do not comply with disease management activities as prescribed. Online patient communities can represent a platform from which to gather specific information outside of a clinical trial setting on patient perception of treatment adherence.

This study aimed to better understand patient perspectives regarding therapeutic adherence and iatrogenic risk in two major groups of NCDs for which poor disease management can have fatal consequences: cardiovascular diseases and mental disorders. Therapeutic adherence, motivational factors, patient awareness and perception of iatrogenesis, and treatment tools used by patients were assessed.

An online survey was performed among patients with cardiovascular diseases and/or mental disorders who were registered on the French Carenity platform, an online community in which patients with an NCD can share experiences and receive support and information. The study inclusion criteria were defined as follows: adults with a diagnosis of cardiovascular disease and/or mental disorder, ≥18 years of age, residing in France, registered on the French Carenity platform and undergoing pharmaceutical treatment for their illness. The patients that met the inclusion criteria were then invited to complete a self-administered online questionnaire, which included questions addressing therapeutic adherence and iatrogenic risk.

A total of 820 patients were enrolled in the study which included patients with cardiovascular diseases (403/820, 49.2%), mental disorders (292/820, 35.6%), and both (125/820, 15.2%). The mean age of the participants was 55.2±12.7 years. It was found that 82.8% (679/820) of patients experienced medication side effects. Patients tended to perceive themselves as more adherent than they actually were, as a significant number of patients disregarded their prescription and stopped or interrupted a medication without consulting with a doctor. Patients with cardiovascular disease were nearly twice as adherent as patients with a mental disorder (P≤.001). Gender, age, and treatment complexity were significantly associated with adherence. Finally, for each disease type, three patient profiles were identified that provide significant insight to improve therapeutic adherence and adapt strategies specifically according to patient behavior.

This study provides insight into the perspectives of patients undergoing therapy for cardiovascular disease and/or mental disorder, which could help to improve the management of NCDs and prevent premature death. Our study also shows that online patient platforms provide new opportunities to improve disease management based on patient experiences.