Investigation of etiological factors and evaluation of compliance in patients with craniomandibular disorder
Ioannis AETOPOULOS, Panagiotis BAMIDIS, Pavlos SARAFIS, Christina DIMONI, Robert HORNE
From the Hellenic Open University, School of Social Sciences, Health Care Management
Hellenic Archives of Oral & Maxillofacial Surgery (2018) 2, 105-124
SUMMARY: Aim: The aim of this study was to evaluate compliance in treatment of patients with temporo- mandibular joint disorders and to investigate the associ- ation of specific factors with compliance.
Material and Methods: The studied population consisted of 122 patients with temporomandibular joint disorders. A questionnaire with closing questions was used, consist- ing of the BIPQ questionnaire for illness perception, the DISQ questionnaire which is a patient-based instrument for providing feedback to doctors on their interpersonal skills within the consultation, the BMQ questionnaire which explores both patient’s medication-taking behavior and barriers to adherence. The socio-demographic data of the patients, clinical information and medical history data, and Clinics, were evaluated also. Compliance was assessed by questionnaire with closing questions, which the patients themselves completed.
Results: Among the 122 patients, 28 were male (23%) and 94 were female (77%). Patient compliance calculated to 52.4%. Significant statistical correlation was not found for all the factors investigated. Positive correlation with compliance has been found for some factors such as age, educational level, disease duration, perception of disease and drugs.
KEY WORDS: Compliance, temporomandibular joint, ad- herence, occlusal splint, beliefs about medicines
REFERENCES
Αντωνιάδης, Κ., Βαχτσεβάνος, Κ., Τηλαβερίδης, Ι., Αετόπουλος, Ι., & Κεχαγιάς, Ν. (2015). Στοματική Χειρουργική. [ηλεκτρ. βιβλ.]. Αθήνα: Σύνδεσμος Ελληνικών Ακαδημαϊκών Βιβλιοθηκών.
Broadbent, E., Petrie, K., Main, J., & Weinman, J.: The Brief Illness Per- ception Questionnaire. Journal of Psychosomatic Research, 60, pp. 631-637, 2006.
Chan, A. H., Stewart, A. W., Foster, J. M., Mitchel, E. A., Camargo, C. A., & Harrison, J.: Factors associated with medication adherence in school-aged children with asthma. ERJ Open Research, 2 (1), pp. 00087-2015, 2016.
Crawshaw, J., Auyeung, V., Ashworth, L., Norton, S., & Weinman, J.: Healthcare provider-led interventions to support medication ad- herence following ACS: a meta-analysis. Open Heart, 4 (2), p. 685, 2017.
Δημόνη, Χ.: Επίδραση συμπτωμάτων και παρενεργειών στις αντιλήψεις και συμμόρφωση ασθενών με HIV/AIDS στην αντιρετροϊκή αγωγή. Διδακτορική Διατριβή. Αθήνα: Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών, 2008.
DiMatteo, M.: Patient adherence to pharmacotherapy: the importance of effective communication. Formulary, 30, pp. 596-8, 1995.
DiMatteo, M., & Martin, L.: Η διαδικασία παροχής ιατρικής φροντίδας. In Φ. Αναγνωστόπουλος, & Γ. Ποταμιάνος (Eds.), Εισαγωγή στην ψυχολογία της Υγείας (Ε. Ραρή, Trans.), 2011, Αθήνα: ΠΕΔΙΟ.
Dimitroulis, G., Gremillion, H., Dolwick, M., & Walter JH.: Temporo- mandibular disorders. 2. Non-surgical treatment. Aust Dent J , 40 (6), pp. 372-6, 1995.
Ferdinand, K. C., Senatore, F. F., Clayton-Jeter, H., Cryer, D. R., Lewin,
J. C., Nasser, S. A., et al.: Improving medication adherence in car- diometabolic disease: Practical and regulatory implications. Journal of the American College of Cardiology, 69 (4), pp. 437-451, 2017.
Garay-Sevilla, M., Nava, L., Malacara, J., Huerta , R., Diaz de Leon, J., Mena, A., et al.: Adherence to treatment and social support in pa- tients with non-insulin dependent diabetes mellitus. J Diabetes Complications, 9 (2), pp. 81-6, 1995.
Gellad, W., Grenard, J., & Marcum, Z.: A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity. Am J Geriatr Pharmacother, 9 (1), pp. 1-23, 2011.
Greco, M., Cavanagh, M., Brownlea, A., & McGovern, J.: The Doctors' Interpersonal Skills questionnaire (DISQ): a validated instrument for use in GP training. Educ Gen Pract, 10, pp. 256-264, 1999.
Horne, R., Weinman, J., & Hankins , M.: The Belief about Medicines Questionnaire: The Development and Evaluation of a New Method Assessing the Cognitive Representation of Medication. Psychology & Health, 14, pp. 1-24, 1999.
Iskedjian, M., Einarson, T., MacKeigan, L., Shear, N., Addis, A., Mittmann, N., et al.: Relationship between daily dose frequency and adher- ence to antihypertensive pharmacotherapy: evidence from a meta-analysis. Clin Ther, 24 (2), pp. 302-16, 2002.
Jin, J., Sklar, G. E., Min Sen Oh, V., & Chuen Li , S.: Factors affecting therapeutic compliance: A review from the patient's perspective. Ther Clin Risk Manag , 4, pp. 269-86, 2008.
Karademas, E. C., Bakouli, A., Bastounis, A., Kallergi, F., Tamtami, P., & Theofilou, M.: Illness perceptions, illness-related problems, subjective health, and the role of perceived primal threat: Pre- liminary results. Journal of Health Psychology, 13, pp. 47-55, 2008.
Kaur, T., Krishnan, G., & Sharma, A.: Factors influencing treatment plan and post operative compliance in TMJ Ankylosis Patients: A ret- rospective analysis of long term post surgical evaluation. Journal of Maxillofacial & Oral Surgery, 14 (1), pp. 17-23, 2015.
Krueger, K., Botermann, L., Schorr, S., Griese-Mammen, N., Laufs, U., & Schulz, M.: Age-related medication adherence in patients with chronic heart failure: A systematic literature review. Int J Cardiol, 184, pp. 728-35, 2015.
Lam, W., & Fresco, P.: Medication adherence measures: An overview.
BioMed Research International, 2015, p. 217047, 2015.
LeResche, L.: Epidemiology of temporomandibular disorders: Implica- tions for the investigation of etiologic factors. Crit Rev Oral Biol Med, 8 (3), pp. 291-305, 1997.
Loffler, W., Kilian, R., Toumi, M., & Angermeyer, M.: Schizophrenic pa- tients' subjective reasons for compliance and noncompliance with neuroleptic treatment. Pharmacopsychiatry, 36 (3), pp. 105-12,
2003.
Μανώλης, Κ.: Συμμόρφωση ασθενών σε χρόνιες παθήσεις. Διπλωμα- τική εργασία. Πάτρα: Τμήμα Φαρμακευτικής, Πανεπιστήμιο Πα- τρών, 2012.
Margolis, R.: Educational Differences in Healthy Behavior Changes and Adherence Among Middle-aged Americans. Journal of Health and Social Behavior, 54 (3), pp. 353-368, 2013.
Naikmasur, V., Bhargava, P., Guttal, K., & Burde, K.: Soft occlusal splint therapy in the management of myofascial pain dysfunction syn- drome: A follow-up study. Indian J Dent Res, 19, pp. 196-203, 2008.
Νικολογιάννης, Σ.: Η συμμόρφωση στη θεραπεία των χρονίως ασθε- νών στην Ελλάδα της οικονομικής κρίσης. Διπλωματική εργασία. Θεσσαλονίκη: ΕΑΠ, Σχολή Κοινωνικών Επιστημών, Διοίκηση Μονάδων Υγείας, 2015.
Okuno, J., Yanagi , H., & Tomura, S.: Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community? Eur J Clin Pharmacol, 57 (8), pp. 589-94, 2001.
Ong, S., Koh, J. J., Toh, S. E., Chia, K. S., Balabanova, D., McKee, M., et al.: Assessing the influence of health systems on type 2 Diabetes Mellitus awareness, treatment, adherence, and control: A system- atic review. PLoS ONE, 13 (3), p. e0195086, 2018.
Saeed, N. R., & Kent, J. N.: A retrospective study of the costochondral graft in TMJ reconstruction. International Journal of Oral and Max- illofacial Surgery, 32 (6), pp. 606-609, 2003.
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J-P. et al.: Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommen- dations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. Journal of Oral & Facial Pain and Headache, 28(1), 6-27, 2014.
Senior, V., Marteau, T., & Weinman, J.: Self-reported adherence to cho- lesterol-lowering medication in patients with familial hypercholes- terolaemia: the role of illness perceptions. Cardiovasc Drugs Ther, 18 (6), pp. 475-81, 2004.
Seo, M., & Min, S.: Development of a structural model explaining med- ication compliance of persons with schizophrenia. Yonsei Medical Journal, 46 (3), pp. 331-340, 2005.
Sharkness, C., & Snow, D.: The patient's view of hypertension and compliance. Am J Prev Med, 8 (3), pp. 141-6, 1992.
Σκουτέρης, Χ., Κατσικέρης, Ν., & Αγγελόπουλος, Α. Π.: Χειρουργική θεραπεία των παθήσεων της Κροταφογναθικής Διάρθρωσης. In Α. Π. Αγγελόπουλος, & Κ. Αλεξανδρίδης, Σύγχρονη Στοματική και Γναθοπροσωπική Χειρουργική (pp. 636-669), 2004, Αθήνα.
Spikmans, F., Bruj, J., Doven, M., Kruizenga, H., Hofsteenge, G., & van Bokhorst-van der Schueren, M.: Why do diabetic patients not at- tend appointments with their dietitian? J Hum Nutr Diet, 16 (3), pp. 151-8, 2003.
Straight, C., Lee, Y., Liu, G., & Kirby, J.: Duration of oral antibiotic ther- apy for the treatment of adult acne: a retrospective analysis investigating adherence to guideline recommendations and oppor- tunities for cost-savings. J Am Acad Dermatol, 72 (5), pp. 822-7, 2015.
Τσιαδής, Β.: Τρόποι συμμόρφωσης και παρακολούθησης ασθενών μέσω mobile εφαρμογών - Ανάπτυξη σε πλατφόρμα Android. Διπλωματική εργασία. Αθήνα: Εθνικό Μετσόβειο Πολυτεχνείο, 2013.
Wig, A., Aaron, L., Turner, J., Huggins, K., & Truerlove, E.: Short-term clinical outcomes and patient compliance with temporomandibular disorder treatment recommendations. J Orofac Pain, 18 (3), pp. 203-13, 2004.
Yavuz, A., Tuncer, M., Erdogan, O., Gurkan, A., Cetinkaya, R., Akbas, S., et al.: Is there any effect of compliance on clinical parameters of renal transplant recipients? Transplant Proc, 36 (1), pp. 120-1, 2004.
From the Hellenic Open University, School of Social Sciences, Health Care Management
Hellenic Archives of Oral & Maxillofacial Surgery (2018) 2, 105-124
SUMMARY: Aim: The aim of this study was to evaluate compliance in treatment of patients with temporo- mandibular joint disorders and to investigate the associ- ation of specific factors with compliance.
Material and Methods: The studied population consisted of 122 patients with temporomandibular joint disorders. A questionnaire with closing questions was used, consist- ing of the BIPQ questionnaire for illness perception, the DISQ questionnaire which is a patient-based instrument for providing feedback to doctors on their interpersonal skills within the consultation, the BMQ questionnaire which explores both patient’s medication-taking behavior and barriers to adherence. The socio-demographic data of the patients, clinical information and medical history data, and Clinics, were evaluated also. Compliance was assessed by questionnaire with closing questions, which the patients themselves completed.
Results: Among the 122 patients, 28 were male (23%) and 94 were female (77%). Patient compliance calculated to 52.4%. Significant statistical correlation was not found for all the factors investigated. Positive correlation with compliance has been found for some factors such as age, educational level, disease duration, perception of disease and drugs.
KEY WORDS: Compliance, temporomandibular joint, ad- herence, occlusal splint, beliefs about medicines
REFERENCES
Αντωνιάδης, Κ., Βαχτσεβάνος, Κ., Τηλαβερίδης, Ι., Αετόπουλος, Ι., & Κεχαγιάς, Ν. (2015). Στοματική Χειρουργική. [ηλεκτρ. βιβλ.]. Αθήνα: Σύνδεσμος Ελληνικών Ακαδημαϊκών Βιβλιοθηκών.
Broadbent, E., Petrie, K., Main, J., & Weinman, J.: The Brief Illness Per- ception Questionnaire. Journal of Psychosomatic Research, 60, pp. 631-637, 2006.
Chan, A. H., Stewart, A. W., Foster, J. M., Mitchel, E. A., Camargo, C. A., & Harrison, J.: Factors associated with medication adherence in school-aged children with asthma. ERJ Open Research, 2 (1), pp. 00087-2015, 2016.
Crawshaw, J., Auyeung, V., Ashworth, L., Norton, S., & Weinman, J.: Healthcare provider-led interventions to support medication ad- herence following ACS: a meta-analysis. Open Heart, 4 (2), p. 685, 2017.
Δημόνη, Χ.: Επίδραση συμπτωμάτων και παρενεργειών στις αντιλήψεις και συμμόρφωση ασθενών με HIV/AIDS στην αντιρετροϊκή αγωγή. Διδακτορική Διατριβή. Αθήνα: Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών, 2008.
DiMatteo, M.: Patient adherence to pharmacotherapy: the importance of effective communication. Formulary, 30, pp. 596-8, 1995.
DiMatteo, M., & Martin, L.: Η διαδικασία παροχής ιατρικής φροντίδας. In Φ. Αναγνωστόπουλος, & Γ. Ποταμιάνος (Eds.), Εισαγωγή στην ψυχολογία της Υγείας (Ε. Ραρή, Trans.), 2011, Αθήνα: ΠΕΔΙΟ.
Dimitroulis, G., Gremillion, H., Dolwick, M., & Walter JH.: Temporo- mandibular disorders. 2. Non-surgical treatment. Aust Dent J , 40 (6), pp. 372-6, 1995.
Ferdinand, K. C., Senatore, F. F., Clayton-Jeter, H., Cryer, D. R., Lewin,
J. C., Nasser, S. A., et al.: Improving medication adherence in car- diometabolic disease: Practical and regulatory implications. Journal of the American College of Cardiology, 69 (4), pp. 437-451, 2017.
Garay-Sevilla, M., Nava, L., Malacara, J., Huerta , R., Diaz de Leon, J., Mena, A., et al.: Adherence to treatment and social support in pa- tients with non-insulin dependent diabetes mellitus. J Diabetes Complications, 9 (2), pp. 81-6, 1995.
Gellad, W., Grenard, J., & Marcum, Z.: A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity. Am J Geriatr Pharmacother, 9 (1), pp. 1-23, 2011.
Greco, M., Cavanagh, M., Brownlea, A., & McGovern, J.: The Doctors' Interpersonal Skills questionnaire (DISQ): a validated instrument for use in GP training. Educ Gen Pract, 10, pp. 256-264, 1999.
Horne, R., Weinman, J., & Hankins , M.: The Belief about Medicines Questionnaire: The Development and Evaluation of a New Method Assessing the Cognitive Representation of Medication. Psychology & Health, 14, pp. 1-24, 1999.
Iskedjian, M., Einarson, T., MacKeigan, L., Shear, N., Addis, A., Mittmann, N., et al.: Relationship between daily dose frequency and adher- ence to antihypertensive pharmacotherapy: evidence from a meta-analysis. Clin Ther, 24 (2), pp. 302-16, 2002.
Jin, J., Sklar, G. E., Min Sen Oh, V., & Chuen Li , S.: Factors affecting therapeutic compliance: A review from the patient's perspective. Ther Clin Risk Manag , 4, pp. 269-86, 2008.
Karademas, E. C., Bakouli, A., Bastounis, A., Kallergi, F., Tamtami, P., & Theofilou, M.: Illness perceptions, illness-related problems, subjective health, and the role of perceived primal threat: Pre- liminary results. Journal of Health Psychology, 13, pp. 47-55, 2008.
Kaur, T., Krishnan, G., & Sharma, A.: Factors influencing treatment plan and post operative compliance in TMJ Ankylosis Patients: A ret- rospective analysis of long term post surgical evaluation. Journal of Maxillofacial & Oral Surgery, 14 (1), pp. 17-23, 2015.
Krueger, K., Botermann, L., Schorr, S., Griese-Mammen, N., Laufs, U., & Schulz, M.: Age-related medication adherence in patients with chronic heart failure: A systematic literature review. Int J Cardiol, 184, pp. 728-35, 2015.
Lam, W., & Fresco, P.: Medication adherence measures: An overview.
BioMed Research International, 2015, p. 217047, 2015.
LeResche, L.: Epidemiology of temporomandibular disorders: Implica- tions for the investigation of etiologic factors. Crit Rev Oral Biol Med, 8 (3), pp. 291-305, 1997.
Loffler, W., Kilian, R., Toumi, M., & Angermeyer, M.: Schizophrenic pa- tients' subjective reasons for compliance and noncompliance with neuroleptic treatment. Pharmacopsychiatry, 36 (3), pp. 105-12,
2003.
Μανώλης, Κ.: Συμμόρφωση ασθενών σε χρόνιες παθήσεις. Διπλωμα- τική εργασία. Πάτρα: Τμήμα Φαρμακευτικής, Πανεπιστήμιο Πα- τρών, 2012.
Margolis, R.: Educational Differences in Healthy Behavior Changes and Adherence Among Middle-aged Americans. Journal of Health and Social Behavior, 54 (3), pp. 353-368, 2013.
Naikmasur, V., Bhargava, P., Guttal, K., & Burde, K.: Soft occlusal splint therapy in the management of myofascial pain dysfunction syn- drome: A follow-up study. Indian J Dent Res, 19, pp. 196-203, 2008.
Νικολογιάννης, Σ.: Η συμμόρφωση στη θεραπεία των χρονίως ασθε- νών στην Ελλάδα της οικονομικής κρίσης. Διπλωματική εργασία. Θεσσαλονίκη: ΕΑΠ, Σχολή Κοινωνικών Επιστημών, Διοίκηση Μονάδων Υγείας, 2015.
Okuno, J., Yanagi , H., & Tomura, S.: Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community? Eur J Clin Pharmacol, 57 (8), pp. 589-94, 2001.
Ong, S., Koh, J. J., Toh, S. E., Chia, K. S., Balabanova, D., McKee, M., et al.: Assessing the influence of health systems on type 2 Diabetes Mellitus awareness, treatment, adherence, and control: A system- atic review. PLoS ONE, 13 (3), p. e0195086, 2018.
Saeed, N. R., & Kent, J. N.: A retrospective study of the costochondral graft in TMJ reconstruction. International Journal of Oral and Max- illofacial Surgery, 32 (6), pp. 606-609, 2003.
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J-P. et al.: Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommen- dations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. Journal of Oral & Facial Pain and Headache, 28(1), 6-27, 2014.
Senior, V., Marteau, T., & Weinman, J.: Self-reported adherence to cho- lesterol-lowering medication in patients with familial hypercholes- terolaemia: the role of illness perceptions. Cardiovasc Drugs Ther, 18 (6), pp. 475-81, 2004.
Seo, M., & Min, S.: Development of a structural model explaining med- ication compliance of persons with schizophrenia. Yonsei Medical Journal, 46 (3), pp. 331-340, 2005.
Sharkness, C., & Snow, D.: The patient's view of hypertension and compliance. Am J Prev Med, 8 (3), pp. 141-6, 1992.
Σκουτέρης, Χ., Κατσικέρης, Ν., & Αγγελόπουλος, Α. Π.: Χειρουργική θεραπεία των παθήσεων της Κροταφογναθικής Διάρθρωσης. In Α. Π. Αγγελόπουλος, & Κ. Αλεξανδρίδης, Σύγχρονη Στοματική και Γναθοπροσωπική Χειρουργική (pp. 636-669), 2004, Αθήνα.
Spikmans, F., Bruj, J., Doven, M., Kruizenga, H., Hofsteenge, G., & van Bokhorst-van der Schueren, M.: Why do diabetic patients not at- tend appointments with their dietitian? J Hum Nutr Diet, 16 (3), pp. 151-8, 2003.
Straight, C., Lee, Y., Liu, G., & Kirby, J.: Duration of oral antibiotic ther- apy for the treatment of adult acne: a retrospective analysis investigating adherence to guideline recommendations and oppor- tunities for cost-savings. J Am Acad Dermatol, 72 (5), pp. 822-7, 2015.
Τσιαδής, Β.: Τρόποι συμμόρφωσης και παρακολούθησης ασθενών μέσω mobile εφαρμογών - Ανάπτυξη σε πλατφόρμα Android. Διπλωματική εργασία. Αθήνα: Εθνικό Μετσόβειο Πολυτεχνείο, 2013.
Wig, A., Aaron, L., Turner, J., Huggins, K., & Truerlove, E.: Short-term clinical outcomes and patient compliance with temporomandibular disorder treatment recommendations. J Orofac Pain, 18 (3), pp. 203-13, 2004.
Yavuz, A., Tuncer, M., Erdogan, O., Gurkan, A., Cetinkaya, R., Akbas, S., et al.: Is there any effect of compliance on clinical parameters of renal transplant recipients? Transplant Proc, 36 (1), pp. 120-1, 2004.

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