Cholesterol control, medication adherence and illness cognition

Abstract

Objective. To examine the relation between illness cognitions and two measures of adherence in patients with hypercholesterolaemia, a disease marked by chronically high cholesterol.Design. Cross-sectional. Based on the self-regulation model (Leventhal, Diefenbach, & Leventhal, 1992), patients' illness cognitions were predicted to be related to cholesterol control and medication adherence. Patients with illness cognitions consonant with an experts' mental model of hypercholesterolaemia were expected to show better control and adherence.Method. Hypercholesterolaemic patients (N = 169) were recruited at a universitybased general medicine clinic. Patients completed a survey that assessed beliefs about hypercholesterolaemia and medication-taking behaviour. Cholesterol levels were obtained from patients' medical charts.Results. Low-density lipoprotein (LDL) cholesterol control was related to believing that hypercholesterolaemia is a stable, asymptomatic disease with severe coronary consequences, and self-report of medication adherence was related to believing that the disease has severe coronary consequences ( ps < .05). LDL cholesterol differences between groups low and high in various illness beliefs ranged between 0.04 and 0.24 mmol/l (2 and 9 mg/dl) which translated to between 1% and 18% lower LDL cholesterol levels.Conclusion. The present study shows several relations that have not been previously demonstrated between better LDL cholesterol control and illness cognition, cognitions that were similar to an expert or physician' s mental model of hypercholesterolaemia. The magnitude of differences in patient cholesterol levels was small but may be clinically important.Coronary heart disease is caused by a number of factors, including elevated cholesterol levels (Knopp, 1999). Patients diagnosed with chronically elevated blood cholesterol

Patient compliance in hypertension: role of illness perceptions and treatment beliefs

“…Patients who have models that differ from medical models of hypertension have been shown to have poorer compliance and higher BPs. 15 We did not find any signficant relationships between cause perceptions and compliance however.…”

“…14 Identity, consequence and specific-necessity were found to relate to compliance in a cohort of haemophiliacs. 15 Again, consequence beliefs were found to predict compliance in a study of patients with hypercholesterolaemia. 16 A recent meta-analysis that looked at studies using the self-regulatory model, but not necessarily the IPQ, showed a correlation between specific problem focused coping strategies (including attendance at appointments and compliance) and perceived controllability.…”

Predictors of Adherence to Statins for Primary Prevention

“…Therefore, patients who maintain inappropriate beliefs about the timeline of treatment or the curative ability of medications will face difficulties with appropriate adherence. The effect of this discordance was demonstrated in a study which found that patients who believed that hyperlipidemia was a long-term stable disease were more adherent [14]. In another study, 58% of statin users reported not knowing the expected duration of treatment [15].…”

“…[10][11][12] Although non-modifiable patient factors such as age, gender, ethnicity, and comorbidity are associated with statin adherence, the relationship has been inconsistent. [13][14][15] Limited understanding of the modifiable patient factors predictive of poor adherence is a key barrier to improving statin adherence. This prospective study was designed to identify potentially modifiable patient factors related to poor adherence.…”

Evaluation of the Symptom Representation Questionnaire (SRQ) for Assessing Cancer-Related Symptoms

“…However, it is these representations that guide how individuals cope with their health problems (7,8). A wealth of literature exists supporting the theory that individual's cognitive and emotional representations about their health problems guide how they cope with those problems (21)(22)(23)(24)(25). In addition, representations have also been shown to predict important health-related outcomes (21,24,(26)(27)(28)(29).…”