New Insights Into Predictors of Antihypertensive Adherence

IF 1.3 4区心理学 Q3 PSYCHOLOGY, CLINICAL

European Journal of Health Psychology Pub Date : 2024-04-01 DOI:10.1027/2512-8442/a000147

M. R. Nikfarjam, Shahram Mohammadkhani, Alireza Moradi, Tahereh Davarpasand, Christina Joanne Pearce

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Abstract

Abstract: Background: Low adherence to treatment is the most common cause of uncontrolled hypertension. Evidence suggests that illness perceptions and the physician-patient relationship may have a combined effect on treatment adherence. Aims: We investigated the roles of illness perceptions and the physician-patient relationship in medication and lifestyle modification adherence, and explained them using patients’ experiences with essential hypertension.Method: In this mixed methods explanatory sequential study, we used questionnaires to assess illness perceptions, the physician-patient relationship, and adherence to medication and lifestyle modification guidance ( N = 112) in the first quantitative phase. Based on the results of regression analyses, the second qualitative phase was planned. We collected data from three patients through interviews, observations and journals, and conducted within-case and cross-case analyses. Finally, we integrated quantitative and qualitative findings. Results: The physician-patient relationship was an independent predictor of medication adherence (95% confidence interval [CI]: 0.29 to 5.89), whereas both illness perceptions (95% CI: −0.32 to −0.04) and the physician-patient relationship (95% CI: 1.05 to 9.48) were independent predictors of adherence to lifestyle modification guidance. Qualitative themes, reflecting the patient’s experience of the concepts explored in this study, explained the quantitative results. Mixing methods revealed high consistency between quantitative and qualitative findings. Limitations: Limitations are the inability to infer causal associations among variables and indirect measurement of medication adherence. Conclusion: Shared decision-making on antihypertensive medications promotes medication adherence. Specifically, the illness perception, perceived illness controllability, and non-judgemental patients’ acceptance within a satisfying physician-patient relationship empower patients to adhere to lifestyle modification guidance.

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抗高血压坚持治疗预测因素的新见解

摘要：背景：治疗依从性低是高血压失控的最常见原因。有证据表明，疾病认知和医患关系可能会对治疗依从性产生综合影响。目的：我们研究了疾病认知和医患关系在坚持药物治疗和生活方式改变中的作用，并利用患者对本质性高血压的经验对其进行了解释：在这项解释性顺序混合方法研究中，我们在第一定量阶段使用问卷评估了疾病认知、医患关系以及坚持药物治疗和生活方式调整指导的情况（N = 112）。根据回归分析的结果，我们计划了第二阶段的定性分析。我们通过访谈、观察和日记收集了三名患者的数据，并进行了病例内分析和交叉分析。最后，我们整合了定量和定性研究结果。研究结果医患关系是药物治疗依从性的独立预测因素（95% 置信区间[CI]：0.29 至 5.89），而疾病认知（95% 置信区间：-0.32 至 -0.04）和医患关系（95% 置信区间：1.05 至 9.48）则是生活方式调整指导依从性的独立预测因素。定性主题反映了患者对本研究探讨的概念的体验，解释了定量结果。混合方法显示，定量和定性结果之间具有高度一致性。局限性：局限性在于无法推断变量之间的因果关系，以及对药物依从性的间接测量。结论：共同决定降压药物可促进服药依从性。具体而言，在令人满意的医患关系中，患者对疾病的感知、对疾病可控性的感知以及非评判性的接受，都会增强患者坚持生活方式调整指导的能力。

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来源期刊

European Journal of Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

3.00

自引率

0.00%

发文量

期刊介绍： Die "Zeitschrift für Gesundheitspsychologie" wurde gegründet, um dem raschen Anwachsen gesundheitspsychologischer Forschung sowie deren Relevanz für verschiedene Anwendungsfelder gerecht zu werden. Gesundheitspsychologie versteht sich als wissenschaftlicher Beitrag der Psychologie zur Förderung und Erhaltung von Gesundheit, zur Verhütung und Behandlung von Krankheiten, zur Bestimmung von Risikoverhaltensweisen, zur Diagnose und Ursachenbestimmung von gesundheitlichen Störungen sowie zur Verbessung des Systems gesundheitlicher Vorsorge.