What affected UK adults' adherence to medicines during the COVID-19 pandemic? Cross-sectional survey in a representative sample of people with long-term conditions.

Aim: Medicines non-adherence is associated with poorer outcomes and higher costs. COVID-19 affected access to healthcare, with increased reliance on remote methods, including medicines supply. This study aimed to identify what affected people's adherence to medicines for long-term conditions (LTCs) during the pandemic. Subject and methods: Cross-sectional online survey of UK adults prescribed medicines for LTCs assessing self-reported medicines adherence, reasons for non-adherence (using the capability, opportunity and motivation model of behaviour [COM-B]), medicines access and COVID-19-related behaviours. Results: The 1746 respondents reported a mean (SD) of 2.5 (1.9) LTCs, for which they were taking 2.4 (1.9) prescribed medicines, 525 (30.1%) reported using digital tools to support ordering or taking medicines and 22.6% reported medicines non-adherence. No access to at least one medicine was reported by 182 (10.4%) respondents; 1048 (60.0%) reported taking at least one non-prescription medicine as a substitute; 409 (23.4%) requested emergency supply from pharmacy for at least one medicine. Problems accessing medicines, being younger, male, in the highest socioeconomic group and working were linked to poorer adherence. Access problems were mostly directly or indirectly related to the COVID-19 pandemic. Respondents were generally lacking in capabilities and opportunities, but disruptions to habits (automatic motivation) was the major reason for non-adherence. Conclusion: Navigating changes in how medicines were accessed, and disruption of habits during the COVID-19 pandemic, was associated with suboptimal adherence. People were resourceful in overcoming barriers to access. Solutions to support medicines-taking need to take account of the multiple ways that medicines are prescribed and supplied remotely. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01813-0.

PUBLIC VIEWS DURING THE CORONAVIRUS PANDEMIC: A UK BASED MIXED METHOD STUDY

Introduction: The coronavirus pandemic presents the greatest challenge to public health in living memory. To slow the spread of the virus the UK initiated periods of strict social distancing, or lockdown. The ongoing social and psychological impacts of the pandemic and lockdowns are still under investigation. We aimed to explore longitudinally the attitudes and behaviors of members of the UK public from the start of UK lockdowns in March, 2020. We focused on mental health, adherence to health behaviours and government regulations, perceptions of vaccinations, and impact on Black, Asian, Minority Ethnic (BAME) participants. Method: Focus groups (2-8 people, 60 min) and surveys were conducted with 57 UK residents from March 23, 2020 to the present at 5 different timepoints that captured lockdowns and firebreaks (93% retention). Participants were 51% Female, mean age 37.1 (Range: 20-60), 72% White, 5% Mixed or Multiple ethnic groups, 16% Asian or Asian British, and 7% Black, African, Caribbean or Black British. Surveys included the Patient Health Questionnaire - Somatic, Anxiety, and Depressive Symptoms (PHQ-SADS), the Capabilities, Opportunities, Motivations and Behaviours questionnaire (COM-B), and coronavirus specific questions such as vaccination intention. Qualitative results: The central theme was that of loss;'practical losses' e.g. income and 'psychological losses' e.g. motivation. Loss improved, but uncertainty and anticipatory anxiety continued across timepoints. Reported mental health issues improved over Summer 2020 and worsened in Nov 2020. Alert fatigue and learned helplessness emerged as the main themes at that time and marginalization by BAME participants. Behavioural adherence and vaccination uptake focused around perception of risk and community vs individual responsibility. Quantitative results: Data will be analysed following the current wave of data collection (Nov-Dec 2021) and will presented in March, 2022. Conclusion: Mental health fluctuated with the ability to socially connect with others outside of the household. Feelings of loss improved over time. Alert fatigue and general mistrust in government increased as did learned helplessness resulting in a loss of motivation. Results have had a significant policy and media impact in the UK and resulted in several publications to date.