Psychosocial and behavioral correlates of self-efficacy in treatment adherence in older patients with comorbid hypertension and type 2 diabetes
Słowa kluczowe:
adherence, self-efficacy, type 2 diabetes mellitus, hypertension, chronicityAbstrakt
Background
Adhering to clinical prescriptions is known to protect against the effects of uncontrolled hypertension and of acute and chronic cardiovascular diseases, including diabetes. Contextually, positive associations between self-care behaviors and psychological constructs, such as self-efficacy, are widely acknowledged in the literature. However, still little is known about the psychological factors underlying the patient’s self-efficacy. This study aimed to investigate the psychosocial and behavioral correlates of self-efficacy related to treatment adherence in older patients with comorbid hypertension and type 2 diabetes mellitus.
Participants and procedure
Italian and Polish patients (≥ 65 years; N = 180) consecutively responded to self-report questionnaires measuring psychosocial (i.e., beliefs about medicines, perceived physician’s communication effectiveness, medication-specific social support, self-efficacy) and behavioral factors (i.e., pharmacological adherence, medications refill adherence, intentional non-adherence) related to treatment adherence. Betweengroup comparisons and regression analyses were performed.
Results
Fisher’s least significant difference (LSD) test showed significant differences between the Italian and Polish groups in all questionnaires (p < .01) with the Italian patients reporting more satisfactory scores. Younger age (β = .08, p = .045), female gender (β = 1.03, p = .042), higher medication refills adherence (β = –.07, p = .024), lower intentional non-adherence (β = –.03, p = .009), positive beliefs about medications (β = .13, p < .001), better quality of communication with the physician (β = .09, p < .001), and stronger perceived medication-specific social support (β = .06, p = .001) were significantly associated with self-efficacy related to treatment adherence.
Conclusions
Future research and interventions should leverage psychosocial and behavioral factors to address self-efficacy contributing to enhancing adherence to clinical prescriptions.
Downloads
Bibliografia
Adamczyk, K. (2013). Development and validation of the Polish-language version of the Multidimensional Scale of Perceived Social Support (MSPSS). Revue Internationale de Psychologie Sociale, 26, 25–48.
Al-Noumani, H., Wu, J. R., Barksdale, D., Sherwood, G., AlKhasawneh, E., & Knafl, G. (2019). Health beliefs and medication adherence in patients with hypertension: a systematic review of quantitative studies. Patient Education and Counseling, 102, 1045–1056. https://doi.org/10.1016/j.pec.2019.02.022
Argentero, P., Torchio, E., Tibaldi, G., Horne, R., Clatworthy, J., & Munizza, C. (2010). The beliefs about drug treatments. The Italian version of the BMQ (the Beliefs about Medicines Questionnaire): its validity and applicability. Epidemiologia e Psichiatria Sociale, 19, 86–92. https://doi.org/10.1017/S1121189X00001640
Bandura, A. (1998). Health promotion from the perspective of social cognitive theory. Psychology & Health, 13, 623–649. https://doi.org/10.1080/08870449808407422
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates.
Di Fabio, A., & Palazzeschi, L. (2015). Multidimensional Scale of Perceived Social Support (MSPSS): un contributo alla validazione italiana [Multidimensional Scale of Perceived Social Support (MSPSS): a contribution to Italian validation]. Counseling, 8, 1–15.
DuBois, C. M., Lopez, O. V., Beale, E. E., Healy, B. C., Boehm, J. K., & Huffman, J. C. (2015). Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: a systematic review. International Journal of Cardiology, 195, 265–280. https://doi.org/10.1016/j.ijcard.2015.05.121
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191. https://doi.org/10.3758/BF03193146
Ferrannini, E., & Cushman, W. C. (2012). Diabetes and hypertension: The bad companions. Lancet, 380, 601–610. https://doi.org/10.1016/S0140-6736(12)60987-8
Giardini, A., Martin, M. T., Cahir, C., Lehane, E., Menditto, E., Strano, M., Pecorelli, S., Monaco, A., & Marengoni, A. (2016). Toward appropriate criteria in medication adherence assessment in older persons: Position paper. Aging Clinical and Experimental Research, 28, 371–381. https://doi.org/10.1007/s40520-015-0435-z
Granata, N., Torlaschi, V., Zanatta, F., Giardini, A., Maestri, R., Pavesi, C., Sommaruga, M., Gazzi, L., Bertolotti, G., Sarzi Braga, S., Monelli, M., Zanelli, E., & Pierobon, A. (2022). Positive affect as a predictor of non-pharmacological adherence in older chronić heart failure (CHF) patients undergoing cardiac rehabilitation. Psychology, Health & Medicine. https://doi.org/10.1080/13548506.2022.2077394
Granata, N., Traversoni, S., Kardas, P., Kurczewska-Michalak, M., Costa, E., Midão, L., & Giardini, A. (2020). Methodological features of quantitative studies on medication adherence in older patients with chronic morbidity: a systematic review. Patient Education and Counseling, 103, 2132–2141. https://doi.org/10.1016/j.pec.2020.04.006
Hair, J., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis (7th ed.). Pearson Educational International Horne, R., Chapman, S. C. E., Parham, R., Freemantle, N., Forbes, A., & Cooper, V. (2013). Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the necessity-concerns framework. PLoS One, 8, 1–24. https://doi.org/10.1371/journal.pone.0080633
Jankowska-Polańska, B., Karniej, P., Polański, J., Seń, M., Świątoniowska-Lonc, N., & Grochans, E. (2020). Diabetes mellitus versus hypertensiondoes disease affect pharmacological adherence? Frontiers in Pharmacology, 11, 1157. https://doi.org/10.3389/fphar.2020.01157
Jankowska-Polańska, B., Świątoniowska-Lonc, N., Karniej, P., Polański, J., Tański, W., & Grochans, E. (2021). Influential factors in adherence to the therapeutic regime in patients with type 2 diabetes and hypertension. Diabetes Research and Clinical Practice, 173, 108693. https://doi.org/10.1016/j.diabres.2021.108693
Jankowska-Polańska, B., Zamęta, K., Uchmanowicz, I., Szymańska-Chabowska, A., Morisky, D., & Mazur, G. (2018). Adherence to pharmacological and non-pharmacological treatment of frail hypertensive patients. Journal of Geriatric Cardiology, 15, 153–161. https://doi.org/10.11909/j.issn.1671-5411.2018.02.002
Kang, M., Kim, S., Yoon, S. J., Choi, J. Y., Kim, K., & Kim, C. H. (2017). Association between frailty and hypertension prevalence, treatment, and control in the elderly Korean population. Scientific Reports, 7, 7542. https://doi.org/10.1038/s41598-017-07449-5
Karakurt, P., & Kaşikçi, M. (2012). Factors affecting medication adherence in patients with hypertension. Journal of Vascular Nursing, 30, 118–126. https://doi.org/10.1016/j.jvn.2012.04.002
Karbownik, M. S., Jankowska-Polańska, B., Horne, R., Górski, K. M., Kowalczyk, E., & Szemraj, J. (2020). Adaptation and validation of the Polish version of the Beliefs about Medicines Questionnaire among cardiovascular patients and medical students. PloS One, 15, e0230131. https://doi.org/10.1371/journal.pone.0230131
Karimy, M., Koohestani, H. R., & Araban, M. (2018). The association between attitude, self-efficacy, and social support and adherence to diabetes self-care behavior. Diabetology & Metabolic Syndrome, 10, 86. https://doi.org/10.1186/s13098-018-0386-6
Karmali, K. N., Davies, P., Taylor, F., Beswick, A., Martin, N., & Ebrahim, S. (2014). Promoting patient uptake and adherence in cardiac rehabilitation. The Cochrane Database of Systematic Reviews, 6, CD007131. https://doi.org/10.1002/14651858.CD007131.pub3
Kripalani, S., Risser, J., Gatti, M. E., & Jacobson, T. A. (2009). Development and evaluation of the Adherence to Refills and Medications Scale (ARMS) among low-literacy patients with chronic disease. Value in Health, 12, 118–123. https://doi.org/10.1111/j.1524-4733.2008.00400.x
Lomper, K., Chabowski, M., Chudiak, A., Białoszewski, A., Dudek, K., & Jankowska-Polańska, B. (2018). Psychometric evaluation of the Polish version of the Adherence to Refills and Medications Scale (ARMS) in adults with hypertension. Patient Preference and Adherence, 12, 2661–2670. https://doi.org/10.2147/PPA.S185305
Maffoni, M., Traversoni, S., Costa, E., Midão, L., Kardas, P., Kurczewska-Michalak, M., & Giardini, A. (2020). Medication adherence in the older adults with chronic multimorbidity: a systematic review of qualitative studies on patient’s experience. European Geriatric Medicine, 11, 369–381. https://doi.org/10.1007/s41999-020-00313-2
Magrin, M. E., D’Addario, M., Greco, A., Miglioretti, M., Sarini, M., Scrignaro, M., Steca, P., Vecchio, L., & Crocetti, E. (2015). Social support and adherence to treatment in hypertensive patients: a meta-analysis. Annals of Behavioral Medicine, 49, 307–318. https://doi.org/10.1007/s12160-014-9663-2
Makoul, G., Krupat, E., & Chang, C. H. (2007). Measuring patient views of physician communication skills: Development and testing of the Communication Assessment Tool. Patient Education and Counseling, 67, 333–342. https://doi.org/10.1016/j.pec.2007.05.005
Martin, L. R., & DiMatteo, M. R. (Eds.) (2013). The Oxford handbook of health communication, behawior change, and treatment adherence. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199795833.001.0001
McQuaid, E. L., & Landier, W. (2018). Cultural issues in medication adherence: Disparities and directions. Journal of General Internal Medicine, 33, 200–206. https://doi.org/10.1007/s11606-017-4199-3
Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care, 24, 67–74. https://doi.org/10.1097/00005650-198601000-00007
Náfrádi, L., Galimberti, E., Nakamoto, K., & Schulz, P. J. (2016). Intentional and unintentional medication non-adherence in hypertension: The role of health literacy, empowerment and medication beliefs. Journal of Public Health Research, 5, 762. https://doi.org/10.4081/jphr.2016.762
NCD Risk Factor Collaboration (NCD-RisC) (2017). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet, 389, 37–55. https://doi.org/10.1016/S0140-6736(16)31919-5
O’Neill, D., & Forman, D. E. (2019). Never too old for cardiac rehabilitation. Clinics in Geriatric Medicine, 35, 407–421. https://doi.org/10.1016/j.cger.2019.07.001
Pierobon, A., Giardini, A., Majani, G., Callegari, S., Lenta, F., La Rovere, M. T., & Febo, O. (2016). Into the cognitive constructs related to adherence to treatment in CHD outpatients: The importance of accepting the disease limitations. Monaldi Archives for Chest Disease, 72, 130–138. https://doi.org/10.4081/monaldi.2009.323
Pierobon, A., Sini Bottelli, E., Ranzini, L., Bruschi, C., Maestri, R., Bertolotti, G., Sommaruga, M., Torlaschi, V., Callegari, S., & Giardini, A. (2017). COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation. International Journal of Chronic Obstructive Pulmonary Disease, 12, 2059–2067. https://doi.org/10.2147/COPD.S133586
Qin, W., Blanchette, J. E., & Yoon, M. (2020). Self-efficacy and diabetes self-management in middle-aged and older adults in the United States: a systematic review. Diabetes Spectrum, 33, 315–323. https://doi.org/10.2337/ds19-0051
Rajpura, J., & Nayak, R. (2014). Medication adherence in a sample of elderly suffering from hypertension: Evaluating the influence of illness perceptions, treatment beliefs, and illness burden. Journal of Managed Care Pharmacy, 20, 58–65. https://doi.org/10.18553/jmcp.2014.20.1.58
Ratanawongsa, N., Karter, A. J., Parker, M. M., Lyles, C. R., Heisler, M., Moffet, H. H., Adler, N., Warton, E. M., & Schillinger, D. (2013). Communication and medication refill adherence: The Diabetes Study of Northern California. JAMA Internal Medicine, 173, 210–218. https://doi.org/10.1001/jamainternmed.2013.1216
Scheurer, D., Choudhry, N., Swanton, K. A., Matlin, O., & Shrank, W. (2012). Association between different types of social support and medication adherence. The American Journal of Managed Care, 18, e461–e467.
Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126, 1763–1768. https://doi.org/10.1213/ANE.0000000000002864
Shahin, W., Kennedy, G. A., & Stupans, I. (2019). The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: a systematic review. Patient Preference and Adherence, 13, 1019–1035. https://doi.org/10.2147/PPA.S212046
Shin, S., Jang, S., Lee, T. J., & Kim, H. (2014). Association between non-adherence to statin and hospitalization for cardiovascular disease and all-cause mortality in a national cohort. International Journal of Clinical Pharmacology and Therapeutics, 52, 948–956. https://doi.org/10.5414/CP202132
Shiyanbola, O. O., Unni, E., Huang, Y. M., & Lanier, C. (2018). The association of health literacy with illness perceptions, medication beliefs, and medication adherence among individuals with type 2 diabetes. Research in Social & Administrative Pharmacy, 14, 824–830. https://doi.org/10.1016/j.sapharm.2017.12.005
Sinclair, A., Saeedi, P., Kaundal, A., Karuranga, S., Malanda, B., & Williams, R. (2020). Diabetes and global ageing among 65-99-year-old adults: Findings from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 162, 108078. https://doi.org/10.1016/j.diabres.2020.108078
Świątoniowska-Lonc, N., Polański, J., Tański, W., & Jankowska-Polańska, B. (2020). Impact of satisfaction with physician-patient communication on self-care and adherence in patients with hypertension: Crosssectional study. BMC Health Services Research, 20, 1046. https://doi.org/10.1186/s12913-020-05912-0
Tsimihodimos, V., Gonzalez-Villalpando, C., Meigs, J. B., & Ferrannini, E. (2018). Hypertension and diabetes mellitus. Hypertension, 71, 422–428. https://doi.org/10.1161/HYPERTENSIONAHA.117.10546
Turan, G. B., Aksoy, M., & Çiftçi, B. (2019). Effect of social support on the treatment adherence of hypertension pertension patients. Journal of Vascular Nursing, 37, 46–51. https://doi.org/10.1016/j.jvn.2018.10.005
Vahdat, S., Hamzehgardeshi, L., Hessam, S., & Hamzehgardeshi, Z. (2014). Patient involvement in health care decision making: a review. Iranian Red Crescent Medical Journal, 16, e12454. https://doi.org/10.5812/ircmj.12454
Vrijens, B., De Geest, S., Hughes, D. A., Przemyslaw, K., Demonceau, J., Ruppar, T., Dobbels, F., Fargher, E., Morrison, V., Lewek, P., Matyjaszczyk, M., Mshelia, C., Clyne, W., Aronson, J. K., & Urquhart, J. (2012). A new taxonomy for describing and defining adherence to medications. British Journal of Clinical Pharmacology, 73, 691–705. https://doi.org/10.1111/j.1365-2125.2012.04167.x
Weinman, J., Graham, S., Canfield, M., Kleinstäuber, M., Perera, A. I., Dalbeth, N., & Petrie, K. J. (2018). The Intentional Non-Adherence Scale (INAS): Initial development and validation. Journal of Psychosomatic Research, 115, 110–116. https://doi.org/10.1016/j.jpsychores.2018.10.010
Williams, B., Mancia, G., Spiering, W., Rosei, E. A., Azizi, M., Burnier, M., Clement, D. L., Coca, A., De Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Kreutz, R., Laurent, S., … Zamorano, J. L. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal, 39, 3021–3104. https://doi.org/10.1093/eurheartj/ehy339
Wong, M. C. S., Liu, J., Zhou, S., Li, S., Su, X., Wang, H. H. X., Chung, R. Y. N., Yip, B. H. K., Wong, S. Y. S., & Lau, J. T. F. (2014). The association between multimorbidity and poor adherence with cardiovascular medications. International Journal of Cardiology, 177, 477–482. https://doi.org/10.1016/j.ijcard.2014.09.103
World Health Organization (2003). Adherence to longterm therapies: Evidence for action. Retrieved from https://apps.who.int/iris/handle/10665/42682 [accessed September 16, 2022]
Xie, Z., Liu, K., Or, C., Chen, J., Yan, M., & Wang, H. (2020). An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health, 20, 1227. https://doi.org/10.1186/s12889-020-09274-4
Zanatta, F., Nissanova, E., Świątoniowska-Lonc, N., Pierobon, A., Callegari, G., Olmetti, F., Felicetti, G., Karniej, P., Polański, J., Giardini, A., & Jankowska-Polańska, B. (2020). Psychosocial predictors of selfefficacy related to self-reported adherence in older chronic patients dealing with hypertension: a European study. Patient Preference and Adherence, 14, 1709–1718. https://doi.org/10.2147/PPA.S258999