Beliefs about Medicine and Antihypertensive Medication Adherence among Patients’ Attending a County Referral Hospital in Kenya



Abstract Views
450

Downloads
310

Citations

Share

##plugins.themes.bootstrap3.article.sidebar##

Submitted Apr 15, 2021
Published Jun 21, 2021
10.24018/clinicmed.2021.2.3.56

Abstract viewed = 450 times

Table of Contents

##plugins.themes.bootstrap3.article.main##

Background: Non-adherence with antihypertensive medication and lifestyle recommendations remains a serious problem in many developed and developing countries. Patient’s belief about medication has been consistently found to be a significant predictor of medication adherence in various studies.

Objective: To assess the relationship between hypertension medication beliefs and adherence to hypertension medication among patients attending a county referral hospital in Kenya.

Methods: A Quantitative research design, utilizing a simple random sampling method and a researcher administered structured questionnaire was adapted. Previously validated, Beliefs about Medication Questionnaire (BMQ) and the Morisky’s Medication Adherence Scale (MMAS-4) were utilized. Bivariate analysis was conducted using Chi square test and the Mann Whitney U test while multivariate data analysis was conducted using Binary logistic regression analysis. Odds ratio and 95% confidence intervals were calculated. Results with p values ≤ 0.05 were considered statistically significant.

Results: Data from 96 participants, 55% female and 58% being over the age of 65 years were analyzed. 33.3% of the respondents had a high adherence level. None of the socio-demographic variables were found to be statistically significant to medication adherence using Chi square test analysis. Patients who had lower scores of concerns about medication were more likely to be adherents than their counter parts p=0.001 (OR=1.047; CI (1.019-1.076) likewise lower scores of general overuses predicted medication adherence p=0.001 (OR=1.069; CI=1.026-1.114).

Conclusion: Health workers should formulate interventions to reduce concerns regarding medication, in order to promote adherence as informed by the findings of this study.

Keywords: Adherence, Hypertension, Antihypertensive, Beliefs about Medication.

References

  1. E. Sabatѐ, “Adherence to Long-term therapies: Evidence for action: World Health Organization”. Geneva Switzerland: 2003.
     Google Scholar
  2. World Health Organization. Hypertension; 2018: Available from: https://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/.
     Google Scholar
  3. G.U.P. Iloh, A.N. Amadi,G.O.P. Okafor, A.O. Ikwadima , F.U. Odu, and E.O. Godswill-Uko, “Adherence to lifestyle modification among adult hypertensive Nigerians with essential Hypertension in a Primary care clinic of a tertiary hospital in a resource poor environment of eastern Nigeria”. Brj Med Res, 4(18), PP.3478-90, 2014.
     Google Scholar
  4. R. Al-Ramah, “Adherence to medications and associated factors: A cross-sectional study among Palestinian Hypertensive patients.” J Epidemiol Glob Health, 5(2), PP.125-132, 2015.
     Google Scholar
  5. C.D. Kang, P.P. Tsang, V.T. Li, H.H. Wang, K.G. Li, S.M. Griffiths, et al., “Determinants of medication Adherence and Blood pressure control among hypertensive patients in Hong Kong: A cross-sectional study.” Int J Cardiol, Vol. 182, PP. 250-257, 2015.
     Google Scholar
  6. Institute NEH. Thinking Outside the pillbox: A system-wide approach to improving patient medication adherence for chronic disease: New England Healthcare Institute: 2009.
     Google Scholar
  7. H. Leventhal, L.A. Philips, and E. Burns, “The common sense model of Self-Regulation. A Dynamic framework for understanding illness self-management.” Journal of Behavioral Medicine, Vol. 39(6), PP. 935-946, 2016.
     Google Scholar
  8. R. Horne, J. Weimann, and M. Hankins, “The Beliefs about Medicine Questionnaire: The development and Evaluation of a New Method of assessing the Cognitive Representation of Medication.” Journal of Psychology and Health, Vol, 14(1), PP. 1-24, 1999.
     Google Scholar
  9. D.E. Morisky , A. Ang, M. Krousel-wood, and H. Ward, “Predictive Validity of a Medication adherence Measure in an out-patient setting.” Journal of Clinical Hypertension, Vol. 10(5), PP. 348-354, 2008.
     Google Scholar
  10. L. Achieng, M.D. Josh, E.N. Ogola, and E. Karari, “Adequacy of Blood Pressure Control and Level of adherence with Antihypertensive Therapy.” East African medical Journal, Vol. 10(5), PP. 348-354, 2009.
     Google Scholar
  11. E. Mutua, N.M. Gitonga, B. Mbuthia, N. Muriuki, J. Cheptum, and T. Maingi, “Level of Blood Pressure Control among Hypertensive patients on follow up in a Regional Referral Hospital in Central in Kenya.” Pan African Medical Journal, Vo. 18, PP. 278, 2014.
     Google Scholar
  12. M. Fernandez-Arias, A. Villaorduna, J. Miranda, F. Diez-Canse, and G.Malaga. “Adherence to Pharmacotherapy and medication related beliefs in Patients with Hypertensive in Lima, Peru.” PLosOne. Vol. 9(2), PP. e112875, 2014.
     Google Scholar
  13. S.H.Lo, J.P. Chau, J.M.WOO, D.R.Thompson, and K.C. Choi, “Adherence to antihypertensive medication in older adults with hypertension.” Journal of Cardiovascular Nursing, Vol. 31(4), PP.296-303, 2016.
     Google Scholar
  14. J. Rajpura, and R. Nayak. “Medication adherence in a sample of elderly suffering from hypertension. Evaluating the influence of Illness perceptions, Treatment Beliefs, and Illness Burden.” Journal of Pharmaceutical management Care. Vol. 20(1), PP 50-65, 2014.
     Google Scholar
  15. S. Saarti, A. Hajj, L. Jabbour, A. Sarkisa, et al., “Association between Adherence, Treatment Satisfaction and Illness Perception in Hypertensive Patients.” Journal of Human Hypertension. Vol. 30(5), PP. 341-345, 2016.
     Google Scholar
  16. V. Boima, A. Ademola, A. Odusola, F.Agyekum, C. Nwofor, et al., “Factors Associated with Medical Non-adherence among Hypertensive patients in Ghana and Nigeria.” International Journal of Hypertension, Vol. 10(1155) PP. 205-716, 2015.
     Google Scholar
  17. P. Munter , A. Anderson, J. Charleston, Z. Chen, V. Ford, et al., “Hypertension Awareness, Treatment and control in Adults with Chronic Kidney Disease. Results from the chronic Renal Insufficiency Cohort Study.” American Journal of Kidney Disease. Vol. 55(3), PP. 44-51, March 2010.
     Google Scholar
  18. S. Sontakke, R. Budania, C. Bajait, K. Jaiswal, and S. Pimpalkhute, “Evaluation of Adherence to Therapy in Patients of Chronic Kidney Disease.” Indian Journal of Pharmacology, Vol. 47(6), PP. 668-671, Nov, 2015.
     Google Scholar
  19. E.K. Massey, M. Tielen, M. Laging, D.K. Beck, R. Khemai , et al., “The Role of Goal Cognitions, Illness Perceptions and Treatment Beliefs in Self-Reported Adherence after Kidney Transplantation: A cohort Study.” Journal of Psychosomatic Research, Vol. 75(3), PP. 229-34, Sept, 2013.
     Google Scholar
  20. L. Platt, H. Green and S. Morrissey, “Understanding Adherence in Patients with Coronary Heart Disease: Illness Representation and Readiness to Engage in Healthy Behaviors.” Journal of Australian Psychologist. Vol. 49(2), PP. 127-137, 2014.
     Google Scholar
  21. M.E. Arbabshastan, A. Arbabisarjou, M. Dehghan, S. Iranmanesh, I. Zareban, and S. Pakdel, “Analytical Assessment of Belief about Medicine among Patients with Hypertension. A case study on Patient’s referred to Medical Centers.” Global Journal of Health Science, Vol. 9(2), PP. 102-105, 2016.
     Google Scholar
  22. T. Ruppar, F. Dobbles, and S. DeGeest, “Medication Beliefs and antihypertensive Adherence among Older Adults: A Pilot Study.” Geriatric Nursing, Vol. 33, PP. 89-95, 2012.
     Google Scholar
  23. A. Aflaskeir, “Role of illness and Medication Perception on Adherence to Medication in a Group of Iranian Patients’ with Type 2 Diabetes.” Journal of Diabetes, Vol. 4(3), PP. 243-7, 2012.
     Google Scholar
  24. C. Mahler, K. Hermann, R. Horne, S. Janks, W. Haefeli, and J. Szecsenvi, “Patients’ Beliefs about medicines in a Primary care setting in Germany.” Journal of Education Clinical Practice, Vol. 18(2), PP. 409-413, Apr, 2012.
     Google Scholar
  25. W.M. Sweileh, S.H. Zyoud, R.J. Nab’al, M. Deleq, M.Enaia, et al., “Influence of Patients’ Disease Knowledge and Beliefs about Patients with Type 2 Diabetes Mellitus in Palestine.” BMC Public health, Vol. 14(1), PP. 96-98, 2014.
     Google Scholar
  26. M.J. Raniah, M.S. Waleed, E.A. Adham Saed, and H.Z. SA’ed, “Beliefs about Medicine and Self-reported Adherence among Patients with Chronic Illness: A Study in Palestine.” Journal of Family Medicine and Primary Care, Vol. 3(3), PP. 224-229, 2014.
     Google Scholar
  27. F. Mostafavi , A. Najim, G. Sharifirad, and P. Golshiri, “Beliefs about Medicines in Patients with Hypertension: The Instrument Validity and Reliability in Iran.” Mater SocioMed, Vol. 28(4), PP. 298-302, 2016.
     Google Scholar
  28. T. Yamane. 1967. Statistics, an Introductory Analysis, 2nd Ed., New York: Harper and Row
     Google Scholar
  29. G. O. Young, “Synthetic structure of industrial plastics,” in Plastics, 2nd ed. vol. 3, J. Peters, Ed. New York: McGraw-Hill, 1964, pp. 15-64.
     Google Scholar