Individuals with hypothyroidism suffer from symptoms including impairments to cognition (i.e., “brain fog”). Medication can help reduce symptoms of hypothyroidism; however, brain fog may hinder adherence. The aim of this study was to determine if memory impairment and cognitive failures are related to treatment nonadherence in 441 individuals with hypothyroidism. Participants with a diagnosis of hypothyroidism and currently prescribed a thyroid hormone replacement medication were placed in two groups according to adherence level and compared on validated scales assessing impairments to memory and cognition. Results indicated a significant association between treatment nonadherence and self-reported brain fog, represented by greater cognitive and memory impairments. Nonadherent individuals indicated impairments with prospective, retrospective, and short- and long-term memory; and more cognitive failures, compared to adherent individuals. Findings suggest the importance of interventions to enhance adherence for individuals with brain fog, such as encouraging the use of reminders.
AlomariM.VuddandaP. R.TrenfieldS. J.DodooC. C.VelagaS.BasitA. W.GaisfordS. (2018). Printing T3 and T4 oral drug combinations as a novel strategy for hypothyroidism. International Journal of Pharmaceutics, 549(1/2), 363–369. https://doi.org/10.1016/j.ijpharm.2018.07.062
2.
AloudahN. M.ScottN. W.AljadheyH. S.Araujo-SoaresV.AlrubeaanK. A.WatsonM. C. (2018). Medication adherence among patients with type 2 diabetes: A mixed methods study. PLoS One, 13(12), e0207583. https://doi.org/10.1371/journal.pone.0207583
3.
BriesacherB. A.AndradeS. E.FouayziH.ChanK. A. (2008). Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy, 28(4), 437–443. https://doi.org/10.1592/phco.28.4.437
4.
BroadbentD. E.CooperP. F.FitzGeraldP.ParkesK. R. (1982). The cognitive failures questionnaire (CFQ) and its correlates. British Journal of Clinical Psychology, 21, 1–16. https://doi.org/10.1111/j.2044-8260.1982.tb01421.x
5.
CameronJ.Worrall-CarterL.PageK.RiegelB.LoS. K.StewartS. (2010). Does cognitive impairment predict poor self-care in patients with heart failure?European Journal of Heart Failure, 12, 508–515. https://doi.org/10.1093/eurjhf/hfq042
6.
CappelliC.CastelloR.MariniF.PaolettaA.MarchettiM.SaulloM.CristianoA.PirolaI.GandossiE.FerlinA.CastellanoM. (2018). Adherence to levothyroxine treatment among patients with hypothyroidism: A northeastern Italian survey. Frontiers in Endocrinology, 9, 699. https://doi.org/10.3389/fendo.2018.00699
7.
CooperC.CarpenterI.KatonaC.SchrollM.WagnerC.FialovaD.LivingstonG. (2005). The AdHOC study of older adults’ adherence to medication in 11 countries. American Journal of Geriatric Psychiatry, 13(12), 1067–1076.
8.
Craig WallaceJ. (2004). Confirmatory factor analysis of the cognitive failures questionnaire: Evidence for dimensionality and construct validity. Personality and Individual Differences, 37(2), 307–324.
9.
CrawfordJ.SmithG.MaylorE.Della SalaS.LogieR. (2003). The prospective and retrospective memory questionnaire (PRMQ): Normative data and latent structure in a large non-clinical sample. Memory (Hove, England), 11(3), 261–275. https://doi.org/10.1080/09658210244000027
10.
DiMatteoM. R.Haskard-ZolnierekK. B.MartinL. R. (2012). Improving patient adherence: A three-factor model to guide practice. Health Psychology Review, 6(1), 74–91.
11.
DiMatteoM. R.SherbourneC. D.HaysR. D.OrdwayL.KravitzR. L.McGlynnE. A.KaplanS.RogersW. H. (1993). Physician’s characteristics influence patients’ adherence to medical treatment: Results from the medical outcomes study. Health Psychology, 12(2), 93–102. https://doi.org/10.1037/0278-6133.12.2.93
12.
HawkinsL. A.KilianS.FirekA.KashnerT. M.FirekC. J.SilvetH. (2012). Cognitive impairment and medication adherence in outpatients with heart failure. Heart & Lung: The Journal of Critical Care, 41(6), 572–582. https://doi.org/10.1016/j.hrtlng.2012.06.001
13.
HaysR. D.KravitzR. L.MazelR. M.SherbourneC. D.DiMatteoM. R.RogersW. H.GreenfieldS. (1994). The impact of patient adherence on health outcomes for patients with chronic disease in the medical outcomes study. Journal of Behavioral Medicine, 17(4), 347–360. https://doi.org/10.1007/BF01858007
14.
HeppZ.LageM. J.EspaillatR.GossainV. V. (2018). The association between adherence to levothyroxine and economic and clinical outcomes in patients with hypothyroidism in the US. Journal of Medical Economics, 21(9), 912–919. https://doi.org/10.1080/13696998.2018.1484749
15.
HeppZ.WyneK.ManthenaS. R.WangS.GossainV. (2018). Adherence to thyroid hormone replacement therapy: A retrospective, claims database analysis. Current Medical Research and Opinion, 34(9), 1673–1678. https://doi.org/10.1080/03007995.2018.1486293
16.
IhleA.InauenJ.ScholzU.KönigC.HolzerB.ZimmerliL.BattegayE.TobiasR.KliegelM. (2017). Prospective and retrospective memory are differentially related to self-rated omission and commission errors in medication adherence in multimorbidity. Applied Neuropsychology. Adult, 24(6), 505–511. https://doi.org/10.1080/23279095.2016.1209675
17.
KalichmanS. C.AmaralC. M.SwetzesC.JonesM.MacyR.KalichmanM. O.CherryC. (2009). A simple single-item rating scale to measure medication adherence: Further evidence for convergent validity. Journal of the International Association of Physicians in Aids Care, 8(6), 367–374. https://doi.org/10.1177/1545109709352884
18.
KalraS.KalraB. (2012). Improving compliance in hypothyroidism: What can we do?Thyroid Research and Practice, 9(3), 78.
19.
KliegelM.JägerT. (2006). Can the prospective and retrospective memory questionnaire (PRMQ) predict actual prospective memory performance?Current Psychology, 25(3), 182–191.
20.
LawM. R.ChengL.DhallaI. A.HeardD.MorganS. G. (2012). The effect of cost on adherence to prescription medications in Canada. CMAJ: Canadian Medical Association Journal, 184(3), 297–302. https://doi.org/10.1503/cmaj.111270
21.
MorsaM.LombrailP.BoudailliezB.GodotC.JeantilsV.GagnayreR. (2018). A qualitative study on the educational needs of young people with chronic conditions transitioning from pediatric to adult care. Patient Preference and Adherence, 12, 2649–2660. https://doi.org/10.2147/PPA.S184991
22.
NakanoY.HashimotoK.OhkibaN.OkumaH.MinamiI.TakahashiH.TanakaY.YoshimotoT.YamadaT. (2019). A case of refractory hypothyroidism due to poor compliance treated with the weekly intravenous and oral levothyroxine administration. Case Reports in Endocrinology, 2019, 5986014–5986016. https://doi.org/10.1155/2019/5986014
PatelR.ChangT.GreysenS. R.ChopraV. (2015). Social media use in chronic disease: A systematic review and novel taxonomy. American Journal of Medicine, 128(12), 1335–1350. https://doi.org/10.1016/j.amjmed.2015.06.015
25.
PereiraM. G.PedrasS.MachadoJ. C. (2014). Family variables as moderators between beliefs towards medicines and adherence to self-care behaviors and medication in type 2 diabetes. Families Systems & Health, 32(2), 198–206. https://doi.org/10.1037/fsh0000029
26.
RastP.ZimprichD.Van BoxtelM.JollesJ. (2009). Factor structure and measurement invariance of the cognitive failures questionnaire across the adult life span. Assessment, 16, 145–158.
SamuelsM. H. (2014). Psychiatric and cognitive manifestations of hypothyroidism. Current Opinion in Endocrinology Diabetes and Obesity, 21(5), 377–383. https://doi.org/10.1097/MED.0000000000000089
29.
SharmaK.BeheraJ. K.SoodS.RajputR.SatpalPraveenP. (2014). Study of cognitive functions in newly diagnosed cases of subclinical and clinical hypothyroidism. Journal of Natural Science Biology and Medicine, 5(1), 63–66. https://doi.org/10.4103/0976-9668.127290
30.
SherT.BraunL.DomasA.BellgA.BaucomD. H.HouleT. T. (2014). The partners for life program: A couples approach to cardiac risk reduction. Family Process, 53(1), 131–149. https://doi.org/10.1111/famp.12061
31.
ViswanathanM.GolinC. E.JonesC. D.AshokM.BlalockS. J.WinesR. C. M.Coker-SchwimmerE. J. L.RosenD. L.SistaP.LohrK. N. (2012). Interventions to improve adherence to self-administered medications for chronic diseases in the United States. Annals of Internal Medicine, 157(11), 785–795. https://doi.org/10.7326/0003-4819-157-11-201212040-00538
32.
WekkingE. M.AppelhofB. C.FliersE.ScheneA. H.HuyserJ.TijssenJ. G.WiersingaW. M. (2005). Cognitive functioning and well-being in euthyroid patients on thyroxine replacement therapy for primary hypothyroidism. European Journal of Endocrinology, 153(6), 747–753. https://doi.org/10.1530/eje.1.02025
33.
WilperA. P.WoolhandlerS.LasserK. E.McCormickD.BorD. H.HimmelsteinD. U. (2009). Health insurance and mortality in US adults. American Journal of Public Health, 99(12), 2289–2295. https://doi.org/10.2105/AJPH.2008.157685
34.
ZolnierekK. B. H.DiMatteoM. R. (2009). Physician communication and patient adherence to treatment: A meta-analysis. Medical Care, 47(8), 826–834. https://doi.org/10.1097/MLR.0b013e31819a5acc
