<p>The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: a systematic review</p>

Abstract

Background Patients’ adherence to therapeutic regimes may be influenced by subjective beliefs about chronic conditions. One of the challenges for health professionals in enhancing adherence is taking patients’ understanding into account when giving health advice and/or providing medical treatment. Purpose This review aimed to evaluate the consequent effects of personal and cultural beliefs on medication adherence, in patients with chronic conditions such as hypertension, diabetes mellitus, chronic obstructive pulmonary disease and asthma. Method A systematic review methodology was used. PubMed, CINAHL, EMBASE and PsychINFO, databases were searched for relevant articles. The main terms analyzed were illness perceptions, health beliefs, cultural beliefs, chronic conditions and medication adherence. Results From 2,646 articles, 127 were retained for further assessment, and finally 25 met the inclusion criteria. A cross-sectional questionnaire survey research design was conducted in all included articles. Of these most (n=22) targeted hypertension or diabetes mellitus. A number of personal and cultural based factors were identified as being associated with adherence to medication regimes — 40% of articles (n=10) examined perception of illness, 20% (n=5) health literacy, 16% (n=4) cultural beliefs, 12% (n=3) self-efficacy, 16% (n=4) spiritual and religious beliefs, as well as 20% (n=5) illness knowledge. Statistically significant associations between medication adherence and these personal and cultural factors were found in 80% (n=20) of the included studies. However, the direction of associations varied between studies depending on the factor that was examined. Conclusion This review has evaluated the impact of personal and cultural factors on medication adherence and highlighted the gaps in literature regarding adherence. Further research is required to fully identify the associations between religious beliefs, control beliefs and illness knowledge and medication adherence.

The role of refugee and migrant migration status on medication adherence: Mediation through illness perceptions

“…Medication adherence goes beyond medication consumption and is a reflection of healthy behaviour [7]. Thus, patients' acceptance of medical advice, including medication use, may be influenced by subjective beliefs about diseases [8]. A number of studies have also assumed the view that disease may be a response to social stresses and/or life events and is shaped in part by the nature of the cultural label which is applied to a person's condition [9].…”

“…A sixth factor, illness coherence, has been added more recently to this model to represent overall patient understanding of the illness [12]. Two relatively recent systematic reviews [8,10] have described a significant association between illness perception domains and medication adherence but have also revealed an inconsistency in the direction (positive or negative) of the associations in different studies. Thus, further work is required to clarify the direction of the relationships between illness perception domains and medication adherence.…”

Role of Medication Beliefs on Medication Adherence in Hypertensive Middle Eastern Refugees and Migrants in Australia

“…Patients' cultural beliefs about medication-taking are also factors contributing intentional medication non-adherence (Bussell, Cha, Grant, Schwartz, & Young, 2017). Health care providers should be encouraged to recognize confusion and misconceptions about medications in patients from different cultures and to provide sensitive care to people from diverse ethnic backgrounds to achieve better medication adherence (Shahin, Kennedy, & Stupans, 2019).…”

Personal Health Perceptions as Predictors to Medication Adherence in a Prospective Cohort Study Among Patients with Multiple Sclerosis

“…Higher individual's adherence scores represent better adherence rates. Adherence categories are low (sum score 0-4), medium low (sum score 5-9), medium-high (sum score [10][11][12][13][14] and high (sum score [15][16][17][18]. Internal reliabilities of the ProMas were baseline = 0.83, Time 1 = 0.82 and Time 2 = 0.83.…”

“…The World Health Organization adherence model posits that adherence is determined by the interplay of ve sets of factors: social and economic (e.g., age, ethnicity, education), health care system (e.g., type of insurance), condition-related (e.g., duration, comorbidity), therapy-related (e.g., type of medication, complexity of regimen, side effects) and patient-related (5). Factors most often studied are social-economic and patient-related, as the rst is easier to measure and the latter is considered as potentially modi able in interventions, including perceptions on illness, medication beliefs, habits in medication and affective states (11,12). Most studies on adherence among PwMS examined the social-economic factor and only few studies investigated patientrelated factors (13)(14)(15) or therapy-related (2,(16)(17)(18).…”