OBJECTIVES: To investigate whether social desirability bias contributes to the paradox of older adults reporting high medication adherence despite a greater risk of non-adherence due to polypharmacy and comorbidities.

METHODS: We analyzed cross-sectional data from 308 anonymized adults with atrial fibrillation (AF), surveyed via online panels in the UK and the US, and during outpatient visits at a specialized stroke center in a German hospital. Patients suffering from AF and undertaking long-term treatment were included independently of the type, treatment, or duration of the disease. Participants completed the Adherence Assessment Questionnaire (AAQ), a validated self-report instrument that includes a two-item social desirability scale. Binomial logistic regression was used to estimate associations between age, social desirability, and their interaction with self-reported non-adherence, adjusting for gender, country, and number of medications. Sensitivity analyses using ordinal and linear regression models, as well as moderation estimates, were conducted to assess robustness.

RESULTS: The sample had a mean age of 67.0 years (SD: 13.2), and 33.8% were female. Increasing age and higher social desirability scores were associated with lower odds of reporting non-adherence (OR = 0.97, 95% CI: 0.94-0.99, p = .009 and OR = 0.80, 95% CI: 0.64-1.00, p = .051, respectively). The age-by-social desirability interaction was marginal in the binomial model (OR = 0.98, 95% CI: 0.96-1.00, p = .105), but significant in ordinal (p < .001) and linear (p = .002) regressions. Older adults with higher social desirability scores were especially likely to report better adherence. The moderation analysis (p = .016) confirmed that social desirability bias strengthened the association between age and adherence. No country-level differences were observed.

CONCLUSION: The apparent increase in self-reported adherence with age may reflect response bias rather than true behavioral differences. The tendency of socially desirable response behavior should be considered when interpreting self-reported adherence data.

We used two large retrospective datasets: a German claims dataset and the UK General Practitioner (GP)-based Clinical Practice Research Datalink (CPRD) dataset (2010–2012) to assess the level of persistence and adherence to therapy with glucagon-like peptide-1 (GLP-1) receptor agonists in type 2 diabetes mellitus (T2DM) patients in the United Kingdom (UK) and Germany, also by comparing once- (OD) with twice-a-day (BID) therapy.

Medication non-adherence is a major challenge in the real-life treatment of chronically ill patients. To meet this challenge, adherence interventions with a tailored approach towards patient-specific adherence barriers identified with a reliable and practicable questionnaire are needed. This investigation aimed to develop and validate such a questionnaire, the “Adherence Barriers Questionnaire (ABQ)”.

According to some current guidelines, extended thromboprophylaxis after hip and knee arthroplasties is recommended. Outpatient prophylaxis with low molecular weight heparins (LMWH) is an important part of this prophylaxis, although the rates of adherence to these regimens are unknown. We determined (1) the degree of nonadherence (NA) of patients with LMWH outpatient prophylaxis and (2) whether specific independent factors explain NA.