An investigation on illness perception and adherence among hypertensive patients

Abstract

Successful blood pressure (BP) control requires good adherence to medication and specific health-related behaviors. However, the BP control rate is not optimal, and limited research has focused on the patient's perspective. This study aimed at investigating the illness perceptions of hypertensive patients and how they relate to drug adherence. One hundred and seventeen hypertensive patients enrolled in this study, and data were collected in a family physician clinic of a medical center located in northern Taiwan. The Illness Perception Questionnaire was administered, and medication adherence and demographic data were also collected. Results showed the patients' perceptions of their hypertension, that it was a chronically severe but stable disease, and the patients were confident in the effectiveness of medical treatments and their ability to control their disease. The participants were divided into three clusters by cluster analysis. There were 46.15% participants in the first cluster; they had less negative belief in their illness consequence and less negative emotional responses, but a low personal sense of control. The second cluster (11.97%) had more negative emotional responses and more negative beliefs in their illness consequence, but these individuals scored highly on their personal sense of control and treatment control beliefs. The third cluster (41.88%) had scores between clusters 1 and 2. Cluster 1 had the best drug adherence, and cluster 2 had the worst drug adherence (χ(2) = 7.67, p < 0.05). It may be beneficial for clinical physicians to pay attention to patients' illness perceptions, including their negative emotional response and symptoms, in order to improve their drug adherence.

A systematic review of illness representation clusters in chronic conditions

“…Reasons for exclusion were: (a) not peer reviewed (5 studies); (b) not in English (2 studies); (c) study analysis did not include clustering methods (38 studies); (d) variables other than illness representation subscales were used to create groups (27 studies); (e) illness representation was not measured using the subscales of the IPQ‐R (change scores 6 studies, Brief IPQ 5 studies, other measures 6 studies, 17 studies total); (f) sample population did not have a chronic disease (2 studies); and (g) outcome variables were not health‐related. A total of 12 studies met inclusion criteria (Aujla, Walker, Sprigg, & Vedhara, 2018; Berry, Davies, & Dempster, 2017; Flora, Anderson, & Brawley, 2015; Graham, Rose, Hankins, Chalder, & Weinman, 2013; Harrison et al, 2014; Hobro, Weinman, & Hankins, 2004; Hsiao, Chang, & Chen, 2012; Lin & Heidrich, 2012; Lopes et al, 2018; McCorry et al, 2013; Norton et al, 2014; Turkington, Dempster, & Maguire, 2018).…”

Reviving Research on Medication Attitudes for Improving Pharmacotherapy: Focusing on Adherence

“…There is no similar systematic study using the Health Belief Model that has assessed attitudes toward drugs in nonpsychiatric patients taking medications for other chronic conditions. A few studies of patients' attitudes toward drugs have been conducted in epilepsy [46] and hypertension [47,48], but the only article that systematically applied the Health Belief Model is a review of the literature on drug attitudes toward statins, in which published studies are reinterpreted with the use of this model [49]. …”

Sodium Intake, Dietary Knowledge, and Illness Perceptions of Controlled and Uncontrolled Rural Hypertensive Patients

“…Adherence or orders and information compliance are influenced by patient's beliefs and their health conditions [7]. Some studies have shown negative attitudes of hypertensive patients toward their disease.…”