<p>Psychosocial Predictors of Self-Efficacy Related to Self-Reported Adherence in Older Chronic Patients Dealing with Hypertension: A European Study</p>

Abstract

Non-adherence to clinical prescriptions is widely recognized as the most common cause of uncontrolled hypertension, contributing to develop acute and chronic cardiovascular diseases. Specifically, patients' unintentional non-adherence is related to psychosocial factors as beliefs about medications, perceived physician's communication effectiveness and medication-specific social support. The aim of this study was to observe the impact of these factors on self-efficacy in relation to pharmacological and non-pharmacological self-reported adherence among older chronic patients with hypertension. Patients and Methods: This research had a cross-sectional, observational and multicentre study design. Italian inpatients under rehabilitation, and Polish inpatients/outpatients were recruited. Following a cognitive screening, socio-demographic and clinical characteristics were obtained. Data on clinical and behavioral adherence (i.e., pharmacological adherence, adherence to refill medicines, intentional non-adherence) and psychosocial factors related to treatment adherence (i.e., beliefs about medicines, physician's communication skills, medication-specific social support, psychological antecedents and self-efficacy) were collected with self-report questionnaires. Results: A total of 458 patients were recruited. Fischer's LSD post hoc test revealed significant differences between Italian and Polish samples in all measures (p<0.001). Multiple linear regression analysis showed low self-reported intentional non-adherence (β = −.02, p=0.031), high self-reported adherence to refill medications (β=−.05, p=0.017), high levels of perceived physician's communication effectiveness (β=0.11, p<0.001), positive beliefs about medications (β=0.13, p<0.001), and high perceived medication-specific social support (β=0.05, p<0.001) to predict significantly high patients' self-efficacy in relation to pharmacological and non-pharmacological self-reported adherence. Conclusion: The observed psychosocial and behavioral factors revealed to positively impact on self-efficacy in relation to treatment adherence among older chronic patients dealing with hypertension. In a prevention framework, future studies and clinical practice may consider these factors in order to improve assessment and intervention on adherence in this population.

Impact of satisfaction with physician–patient communication on self-care and adherence in patients with hypertension: cross-sectional study

“…Nonadherence to treatment is the most common cause of treatment failure. Research has identified multiple factors with an impact on adherence and self-care [6,[10][11][12][13][14]. The WHO has defined five groups of factors contributing to non-adherence: (1) patient and familydependent factors, (2) illness-related factors, (3) treatment-related factors, (4) healthcare system-related factors, and (5) socio-demographic and economic factors [15].…”

“…The available data [14,[22][23][24][25], which come mainly from the US, document the role of communication in the physician-patient relationship. Few European reports are available [14,25], and to the best of our knowledge, there have been no Polish studies focusing on the relationship between communication and adherence or self-care in patients with HT.…”

Factors affecting self-efficacy against hypertension self-care in hypertension patients: a scoping review

“…However, the role of belief is influenced by the existence of positive belief in treatment with a value (β=0.13 p <0.001). 27,28 Finding 5: Social support Social support and self-efficacy were found to be significant for physical activity with a value of p <0.01, = 0.45) and social support p<0.01, (β=0.05, p<0.001). 23 This concurs with the results of Hu's research which revealed that support Social family had a relationship with medication adherence and blood pressure measurement with an odds ratio (OR) of 1.39 (95% confidence interval (CI) 1.03-1.87), odds ratio (OR) 1.33 (95% confidence interval (CI) (1.02-1.74).…”

“…Non-adherence to treatment was the cause of uncontrolled hypertension with a score (β=-0.02, p=0.031). 28 Nine studies did not mention that there was intentional non-adherence to factors affecting selfefficacy in hypertension treatment. 21,[23][24][25][26][27]29,30…”

“…The role of motivation is needed in this case, namely to encourage patients to adhere to treatment and maintain an increase in health behavior. 28 Improved health behavior is influenced by exercise, depression, anger, and religion. 26…”