<p>The Association Among Medication Beliefs, Perception of Illness and Medication Adherence in Ischemic Stroke Patients: A Cross-Sectional Study in China</p>

Abstract

To examine the association and the mediating effect among medication beliefs, perception of illness, and medication adherence in ischemic stroke patients. Patients and Methods: This is a cross-sectional study, 306 ischemic stroke patients recruited from The Second Affiliated Hospital of Harbin Medical University, China between June 2018 and October 2018. The Beliefs about Medications Questionnaire (BMQ) was used to assess a patient's beliefs about medication. The Brief Illness Perceptions Questionnaire (BIPQ) was used to rapidly determine the cognitive and emotional representation of ischemic stroke. Self-reported adherence was assessed using the Medication Adherence Report Scale (MARS). Logistic regression analysis, Pearson correlations, and mediation analysis were used to evaluate the association and mediating effects among medication beliefs, perception of illness, and medication adherence. Results: Overall, 220 (65.48%) participants were non-adherent to their ischemic stroke medications. Non-adherent patients had greater stroke severity (p = 0.031) compared to adherent patients. After adjusting for demographic characteristics, specific concern (odds ratio [OR]: 0.652, 95% confidence interval [CI]: 0.431 to 0.987, p-value [P] = 0.043), and the perception of illness (overall score) (OR: 0.964, 95% CI: 0.944 to 0.985, P = 0.001) were significantly associated with medication adherence in ischemic stroke patients. The mediation analysis showed the significant indirect effects of specific concern, general overuse, and general harm. It suggested that some impacts of medication beliefs have been mediated on medication adherence. Conclusion: Perceived concern about adverse effects of medicines and perception of illness have an influential impact on self-reported medication adherence in ischemic stroke patients. To enhance adherence, patients' beliefs about medication and perceptions of their disease should be reconsidered. Future work should investigate interventions to influence patient adherence by addressing concerns about their ischemic stroke medications and the perception of the disease.

Impact of COVID‐19 outbreak on rheumatic patients’ perceptions and behaviors: A cross‐sectional study

“…The focus of the present study on rheumatic disease management is congruent with the problem faced by rheumatology communities these days. 45,46 Medication non-adherence could lead to increased morbidity, mortality, and healthcare costs. 47,48 However, patients who have misperceptions might be more likely to adhere to their medication if they experienced disease acceptance, therapeutic benefits, or fear of adverse outcomes.…”

“…As such patients who perceived that their disease activity had worsened since the COVID‐19 outbreak were more likely to be not adherent to their medications compared to those with a positive perception. Studies suggested that patients who have poor health perception might adhere less because of misbelief and maladaptive behavior 45,46 . Medication non‐adherence could lead to increased morbidity, mortality, and healthcare costs 47,48 .…”

The Consequences of General Medication Beliefs Measured by the Beliefs about Medicine Questionnaire on Medication Adherence: A Systematic Review

“…Consistently, there is evidence in literature that patient–healthcare provider mistrust was considered as a major problem that has become a common part of the Chinese patient experience [ 41 ]. Patient trust may influence patients’ willingness to continue taking their medications and to stop perceiving their medications as overused [ 42 ]. One of the practical strategies to support this is to encourage healthcare providers to provide care that is concordant with the patient’s values, needs, and preferences, and that allows patients to provide their own input and participate actively in decisions regarding their medications and health [ 43 ].…”

Factors Affecting Health-Promoting Behaviors in Patients with Cardiovascular Disease

“…As an indicator of health in general, health perception is a significant predictor of health outcomes, such as quality of life and health behaviors, affecting disease prognosis and health status [ 23 ]. Nonsmoking status, regular physical activity, healthy diet, adherence to medication and medical recommendations, and psychological well-being are associated with higher perceived health status [ 24 , 25 , 26 , 27 ]. However, the results of studies exploring the interaction between a healthy lifestyle and subjective health perception are not consistent [ 28 ].…”