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

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.