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

Shahin, Wejdan; Kennedy, Gerard; Cockshaw, Wendell; Stupans, Ieva

doi:10.1371/journal.pone.0227326

Cited by 20 publications

(34 citation statements)

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“…The Cronbach's α for both scales of the original English version of the BMQ was 0.76 (Robert Horne, Weinman, & Hankins, 1999), Descriptive statistics including frequencies, percentages, means and standard deviations were calculated for participants' socio-demographics characteristics and all dependent variables. Socio-demographics characteristics for this sample have been published previously (Shahin et al, 2020), and are reproduced here in Table 1. Associations of independent and dependent variables for the two groups were examined using Chi-square tests, and differences between the two groups were examined using t-tests.…”

Section: Discussionmentioning

confidence: 99%

“…Although, both these populations may have similar difficulties during the resettlement processes, a number of factors distinctly differentiate the social and personal lives of refugees and migrants. These factors may include: the intentions and motivations for migration, the impediments to returning back to home countries, having a control over their lives through migration, and taking into account the damaging effect of persecution on their education, employment, and socioeconomic status (Shahin et al, 2020). Therefore, these two different populations might evolve different beliefs about their medications.…”

Section: According To the 1951 Convention Relating To The Status Of Rmentioning

confidence: 99%

“…Facebook was also used to recruit refugees and migrants through Arabic community groups that included large populations of Middle Eastern refugees and migrants who were sharing their experiences and interests via these groups. The recruitment process, and data collection were previously reported (Shahin et al, 2020). Ethics approval for this study was obtained from RMIT University Ethics Committee, (SEHAPP 53-18).…”

Section: Study Design and Settingmentioning

confidence: 99%

“…Throughout the 10-month recruitment period, attendees at Adult Migrant English Program centres and the community groups, were approached and invited to consider participating in the study. A poster including the survey link was published in some Facebook Arabic interest gathering groups in Australia (Shahin et al, 2020). Participants were invited to take part in the study if they were aged 30 years or older, diagnosed with hypertension, and had migrated to Australia from one of the 22 countries in the Middle East, as refugees or migrants.…”

Section: Study Participantsmentioning

confidence: 99%

“…In 2015, 5.8% of the total burden of disease in Australia was due to high blood pressure (AIHW, 2019). The effective control of hypertension requires patients to adopt and maintain a healthy lifestyle and take medication regularly (Shahin, Kennedy, Cockshaw, & Stupans, 2020). However, medication non-adherence constitutes a significant obstacle to hypertension care worldwide with a prevalence between 20% and 50% (Nafradi, Galimberti, Nakamoto, & Schulz, 2016).…”

Section: Introductionmentioning

confidence: 99%

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

Shahin

Kennedy

Cockshaw

et al. 2020

Preprint

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BackgroundAdherence to medication is essential in some patients for achieving treatment control in hypertension. Medication beliefs is one of the personal modifiable factors that has been recognised to influence medication adherence in different populations. However, there is no published research to confirm the relationship between medication beliefs and medication adherence in Middle Eastern refugees and migrants in Australia. These two different groups may develop different beliefs about their medications that lead to different medication taking behaviours. Understanding the possible differences in beliefs may have a significant impact on enhancing medication adherence in these groups.Design320 Middle Eastern refugees and migrants with hypertension were approached via various social groups in Australia and asked to complete Arabic versions of the Beliefs about Medicine Questionnaire (BMQ) and the Medication Adherence Questionnaire. BMQ scores (necessity and concerns scales) were classified as "accepting", "indifferent", "ambivalent" or "skeptical". Multiple mediation modelling was applied to examine the role of necessity and concerns scales as mediators between migration status and medication adherence.ResultsThere were significant associations between medication adherence and medication beliefs scores (necessity and concerns scales) (p = 0.0001). Necessity, and concern were mediators in the relationship between migration status and medication adherence. Significant differences were found between refugees and migrants for medication adherence and medication beliefs. Refugees were likely to have less necessity, and more concern beliefs than migrants. They were also less likely to adhere to medications. Almost 30% of refugees could be classified as skeptical and 40% as ambivalent. In contrast, 50% of migrants had accepting beliefs, and around 35% held ambivalent beliefs. Refugees and migrants with “accepting” beliefs reported the highest adherence to medication and those holding “skeptical” beliefs reported the lowest adherence.ConclusionMedication beliefs are potentially modifiable and are reasonable targets for clinical interventions designed to improve medication adherence. Understanding these beliefs and the likely differences between refugees and migrants is crucial to provide specific and targeted advice to each group independently in order to improve medication adherence and overall health.

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Section: Discussionmentioning

confidence: 99%

Section: According To the 1951 Convention Relating To The Status Of Rmentioning

confidence: 99%

Section: Study Design and Settingmentioning

confidence: 99%

Section: Study Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Shahin

Kennedy

Cockshaw

et al. 2020

Preprint

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Acculturation and glycaemic control in Arab immigrants with type 2 diabetes in Australia

Alzubaidi,

Oliveira,

Samorinha

et al. 2024

Diabetologia

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Aims/hypothesis This study aimed to investigate acculturation’s direct and mediated effects on HbA1c levels in individuals with type 2 diabetes from Arabic-speaking countries that are members of the Arab League who have emigrated to Australia. Methods In this multicentre cross-sectional study, we recruited 382 Arabic-speaking immigrants who were born in any of the 22 countries of the Arab League and who had type 2 diabetes from different healthcare settings in Australia. HbA1c levels were retrieved from medical records. A validated self-report questionnaire was used to assess behavioural and psychosocial outcomes. Acculturation was measured using the General Acculturation Index and the Adherence to Traditional Values tool. We used structural equation modelling to test mediation hypotheses. Results Participants had a mean HbA1c value of 63.9 mmol/mol (8.0%), a low acculturation level (mean±SD: 1.9±0.6; range: 1–5) and highly adhered to traditional values (mean General Acculturation Index value: 3.7±0.7; range: 1–5). Higher HbA1c was associated with lower acculturation levels (Pearson correlation coefficient [r] = −0.32, p<0.01) and higher adherence to traditional values (r=0.35, p<0.01). Self-efficacy, health literacy and self-care activities partially mediated the relationship between acculturation and HbA1c. Conclusions/interpretation Among Arab immigrants in Australia with type 2 diabetes, the degree of acculturation is related to glycaemic control, suggesting possible avenues for new interventions. Graphical Abstract

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Initiation of antidepressant use among refugee and Swedish-born youth after diagnosis of a common mental disorder: findings from the REMAIN study

Taipale

Niederkrotenthaler

Helgesson

et al. 2020

Soc Psychiatry Psychiatr Epidemiol

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Purpose The objective of this study was to compare the initiation and type of antidepressant use between refugees and matched Swedish-born youth after a diagnosis of a common mental disorder (CMD) and assess sociodemographic and clinical factors associated with the initiation. Methods The study cohort included youth aged 16–25 years, with an incident diagnosis of CMD based on specialized health care registers in Sweden 2006–2016, without prior antidepressant use during 1 year. One Swedish-born person was matched for each identified refugee youth (N = 3936 in both groups). Initiation of antidepressant use and factors associated with the initiation, were investigated with logistic regression yielding Odds ratios, OR, and 95% Confidence Intervals, CI. Results Refugees were less likely to initiate antidepressant use compared with Swedish-born (40.5% vs. 59.6%, adjusted OR 0.43, 95% CI 0.39–0.48). Selective serotonin reuptake inhibitors (SSRIs) were less frequently initiated for refugees than Swedish-born (71.2% vs. 81.3% of initiations, p < 0.0001). Sertraline was the most commonly initiated antidepressant both for refugees (34.3%) and Swedish-born individuals (40.3%). Among refugees, factors associated with increased odds of antidepressant initiation were previous use of anxiolytics or hypnotics, previous sickness absence of < 90 days, cancer and older age (OR range 1.07–2.72), and less than 5 years duration of residency in Sweden was associated with decreased odds (OR 0.76, 95% CI 0.63–0.92). Conclusion Young refugees with a CMD seem to initiate antidepressants in general and those most effective considerably less often than their Swedish-born counterparts.

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

Cited by 20 publications

References 50 publications

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

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

Acculturation and glycaemic control in Arab immigrants with type 2 diabetes in Australia

Initiation of antidepressant use among refugee and Swedish-born youth after diagnosis of a common mental disorder: findings from the REMAIN study

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