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8 Multiple studies have demonstrated that better adherence is associated with higher necessity beliefs and fewer concerns about treatment.
Higher numbers of clinical complications were associated with higher necessity of DFO and higher Sensitive Soma score.
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It has been proposed that patients carry out an internal 'cost-benefit' analysis with regards to taking medicines, weighing up their perceived necessity and their concerns about the treatment [ 8]. High self-reported adherence to medications for chronic conditions in adults has been associated with high necessity beliefs and low concern beliefs using a necessity-concerns framework [ 6].
These data show that this effort pays off with high necessity-concern scores.
Conducting a cross-sectional study, the authors found that higher necessity scores correlate with higher reported adherence, whereas higher concerns correlate with lower reported adherence [ 36].
Regular receipt of an updated medication list was associated with higher perceived necessity of the medication, while the memory of a "brown bag review" was negatively associated with perceived necessity.
In our study, patients who found their medication list most comprehensive had less concerns towards their medication and regular receipt of an updated medication list was associated with higher perceived necessity of the medication.
Regularly transfused patients reported a higher necessity of DFO chelation.
Higher necessity scores indicate higher beliefs that transfusion/chelation is necessary for their health.
Consistent with the development of the scales [ 2], high necessity and concerns were defined as scores above the midpoint, and four groups were defined: accepting (high necessity, low concerns), ambivalent (high necessity, high concerns), indifferent (low necessity, low concerns), and skeptical (low necessity, high concerns) [ 11].
Of those on transfusion therapy, 96% reported high necessity (> midpoint of 15 points), with 48% reporting high concerns.
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