Self-reported Adherence Behavior in Adolescent Hypertensive Patients: The Role of Illness Representations and Personality

Žugelj, Urška; Zupančič, Maja; Komidar, Luka; Kenda, Rajko B.; Varda, Nataša Marčun; Gregorič, Alojz

doi:10.1093/jpepsy/jsq027

Cited by 50 publications

(49 citation statements)

References 35 publications

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“…subscale) has been previously correlated with different measures of medication adherence in asthma 164 and other chronic conditions, 80,169,172,173,175,[178][179][180][181] this is the first study to find that the relationship is moderated by perceived understanding of asthma. This suggests that addressing treatment control beliefs is likely to be more effective in individuals with poor understanding than those with a good understanding of asthma.…”

Section: * Represents An Interaction Effectmentioning

confidence: 70%

“…Treatment control perceptions has been previously reported to be a predictor of adherence in asthma 164 and other chronic conditions. 80,169,172,173,178,179,181 These beliefs appear particularly important for adherence in asymptomatic conditions because the treatment may not cause any noticeable changes in the condition (e.g. symptom relief) and this may lead the individual to believe there is no need for their medication.…”

Section: Locus Of Controlmentioning

confidence: 99%

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Exploring the relationship between health beliefs and medication adherence in individuals with asthma

Foot¹,

Caze²,

Gujral³

et al.

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In individuals with asthma, non-adherence to inhaled corticosteroids contributes to increased exacerbations, healthcare utilisation and mortality. Understanding the beliefs an individual holds about their medicines, illness and about the controllability of their health provides a promising way to better understand non-adherence in individuals with chronic conditions. Research to date has focussed on bivariate relationships between a specific set of beliefs and medication adherence. This approach simplifies the complex, multifaceted nature of medication adherence. I suggest that investigating how different beliefs associate with medication adherence in a multivariable model may improve understanding of adherence decisions.The aim of the thesis is to investigate the relationship between beliefs about medicines, illness perceptions and locus of control beliefs with self-reported medication adherence in individuals with asthma.The first part of the thesis was to identify whether beliefs about medicines, elicited through the Beliefs about Medicines Questionnaire (BMQ), were correlated to medication adherence on a population level. The BMQ consists of two scales that seek to elicit an individual's beliefs in the necessity and concerns of taking medication. Necessity beliefs reflect medicines being protective of current and future health and concern beliefs reflect beliefs about the negative effects of medicines. Beliefs about medicines are thought to play a key role in medication-taking, but inconsistent results across different conditions and different measures of adherence makes it difficult to conclude the size of the effect at a population level. A meta-analysis was conducted to identify whether beliefs in the necessity and concerns of medicines, were significantly correlated with medication adherence across different conditions. An electronic search was conducted for manuscripts comparing scores from the BMQ to measures of medication adherence. Studies were pooled using the random-effects model to produce a mean effect size correlation. Studies were stratified for condition, adherence measure, power and study design. Ninety-four papers were included and the overall effect size correlation was 0.17 for necessity and -0.18 for concerns (p<0.0001). Necessity and concerns beliefs were correlated with medication adherence on a population level and across the majority of included conditions. The effect sizes were small with a magnitude comparable to other predictors of adherence. Exploring the role of beliefs outside the Beliefs about Medicines Framework may improve prediction and understanding of medication adherence.A cross-sectional study was conducted to explore the relationship between measures of health beliefs and medication adherence in individuals with asthma. A total of 198 participants using a preventative asthma inhaler for three or more months were recruited from two community pharmacies and via iii online advertisement. Each participant completed a survey of validated questionnaires consisting of:...

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Section: * Represents An Interaction Effectmentioning

confidence: 70%

Section: Locus Of Controlmentioning

confidence: 99%

Exploring the relationship between health beliefs and medication adherence in individuals with asthma

Foot¹,

Caze²,

Gujral³

et al.

View full text Add to dashboard Cite

show abstract

“…95,120,[126][127][128][129][130][131] Patient's perceptions and understanding of their illness and treatment have been shown to be associated with medication adherence. 40,95,[125][126][127][132][133][134][135] There are a number of different scales used to assess health perceptions including the Health Perception Questionnaire (HPQ), Illness Perception Questionnaire (IPQ), Illness Perception Questionnaire -Revised (IPQ-R) and Brief Illness Perception Questionnaire (BIPQ). [136][137][138][139] The IPQ was developed based on the Self-Regulatory Theory to assess the cognitive representations of illness:…”

Section: Patient-related Factorsmentioning

confidence: 99%

“…125 Patients with high blood pressure who were more likely to be adherent, had greater perceived personal ability to control blood pressure, exhibited greater concerns about their illness and had less emotional burden, based on the BIPQ. 135 Past medication adherence has been shown to predict adherence. 77,140 For example, the best single predictor of future adherence in patients with schizophrenia was found to be nonadherence in the prior six months.…”

Section: Patient-related Factorsmentioning

confidence: 99%

“…135,139 For example, patients with hypertension were more likely to be adherent if they felt they had good control over their illness, better understanding of their illness and were not emotionally affected by their illness. The BIPQ consists of nine items that assess the cognitive and emotional representations of illness.…”

Section: Brief Illness Perception Questionnaire (Bipq)mentioning

confidence: 99%

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Improving medication adherence in patients with chronic disease using a targeted and tailored approach

Nguyen¹

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Improving adherence to medications is an opportunity that can yield great improvements in health outcomes and reducing health costs. Supporting adherence to medicines requires insight into a patient's medication-taking behaviour and their reasons for non-adherence.Adherence interventions that show most promise include multifaceted interventions, and those targeted to non-adherent patients and/or tailored to patient-specific reasons for nonadherence. To identify non-adherent patients and their reasons for non-adherence in the practice setting, I argue that we require inexpensive measures that are easy to use and can inform the discussion with patients about their adherence. Adherence scales are inexpensive, easy-to-administer and have the potential to explore both medication-taking behaviour and reasons for behaviour.The overall aim of the thesis is to determine if a targeted and tailored intervention based on a discussion informed by validated adherence scales, will improve adherence to a recently initiated cardiovascular medication. I hypothesise that targeting and tailoring an intervention to non-adherent participants based on a discussion informed by adherence scales, will improve adherence at three months as measured by the four-item Medication Adherence Questionnaire (MAQ). I will also test whether improvements in adherence at three months are sustained at six months and explore the changes in adherence and reasons for nonadherence over time.The first part of the thesis involved identifying validated adherence scales suitable for use in the intervention. A systematic review was conducted on adherence scales to explore their use and validation. We found that adherence scales measured different aspects of adherence: medication-taking behaviour, barriers to adherence and beliefs associated with adherence. Adherence scales have been validated in different disease populations and against different measures of adherence. We selected two adherence scales for our study: the MAQ and Beliefs about Medicines Questionnaire-Specific (BMQ-S). The MAQ is one of the most commonly used adherence scales that has been validated in many disease populations and against different measures of adherence including electronic monitoring.The BMQ-S has been extensively used to elicit medication beliefs associated with medication adherence and validated in a number of diseases including cardiovascular disease, asthma and depression.A randomised controlled trial was conducted to determine if a targeted and tailored intervention would improve medication adherence. Four hundred and eight patients were iii assessed for eligibility from two community pharmacies, from which 152 patients were enrolled into the study. All enrolled participants completed the MAQ, BMQ-S and Brief Illness Perceptions Questionnaire (BIPQ). There were 120 participants identified as non-adherent using the MAQ, who were randomised into an intervention or control group. The remaining 32 participants were identified as adherent. In the intervention group, the r...

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Liver transplantation and adolescence: The role of mental health

et al. 2016

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Young people (YP) with chronic illness have higher rates of mental health problems than the general population, with psychosocial complexity associated with nonadherence and poorer health outcomes. This study aimed to describe the prevalence of anxiety and depression in YP after liver transplantation, with autoimmune liver disease and other chronic liver diseases, identify the factors YP attribute their distress to and the relationship between anxiety/depression, and describe YP's beliefs about their illness and treatment. An electronically administered questionnaire battery was given routinely to YP attending an outpatient liver transition clinic; 187 YP participated, of which 17.7% screened positive for anxiety or depression. There were no significant differences between disease groups. This is significantly higher than the prevalence of common mental health problems in the general adolescent population. Patients most frequently attributed their distress to fatigue, sleep difficulties, financial concerns, problems at work/school, worry, and low self-esteem. Higher levels of depression and anxiety were significantly associated with specific illness and treatment beliefs but not with perceived understanding of illness or treatment control. In conclusion, the increased prevalence of mental health problems in YP and the intertwined nature of these with their physical health outcomes provide evidence that holistic care should be delivered as standard for this age group. Liver Transplantation 22 1544-1553 2016 AASLD.

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Self-reported Adherence Behavior in Adolescent Hypertensive Patients: The Role of Illness Representations and Personality

Cited by 50 publications

References 35 publications

Exploring the relationship between health beliefs and medication adherence in individuals with asthma

Exploring the relationship between health beliefs and medication adherence in individuals with asthma

Improving medication adherence in patients with chronic disease using a targeted and tailored approach

Liver transplantation and adolescence: The role of mental health

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