Key result
Positive medication beliefs, effective communication, and social support link to higher adherence self-efficacy in hypertension.
Why the study?
Non-adherence is the leading cause of uncontrolled hypertension, but the impact of psychosocial factors on self-efficacy regarding treatment adherence in older hypertensive patients needed evaluation.
Do psychosocial and behavioral factors predict self-efficacy related to treatment adherence in older patients with hypertension?
Cross-Sectional (n=458)
Yes
Do psychosocial and behavioral factors predict self-efficacy related to treatment adherence in older patients with hypertension?
Psychosocial factors and effective physician communication are important determinants of self-efficacy and self-reported adherence in older adults with hypertension, highlighting the need for patient-centered approaches to disease management.
May inform targeted strategies to enhance adherence self-efficacy; hypothesis-generating and requires prospective validation before practice implications.
PURPOSE: Non-adherence to clinical prescriptions is widely recognized as the most common cause of uncontrolled hypertension, contributing to develop acute and chronic cardiovascular diseases. Specifically, patients' unintentional non-adherence is related to psychosocial factors as beliefs about medications, perceived physician's communication effectiveness and medication-specific social support. The aim of this study was to observe the impact of these factors on self-efficacy in relation to pharmacological and non-pharmacological self-reported adherence among older chronic patients with hypertension. PATIENTS AND METHODS: This research had a cross-sectional, observational and multicentre study design. Italian inpatients under rehabilitation, and Polish inpatients/outpatients were recruited. Following a cognitive screening, socio-demographic and clinical characteristics were obtained. Data on clinical and behavioral adherence (i.e., pharmacological adherence, adherence to refill medicines, intentional non-adherence) and psychosocial factors related to treatment adherence (i.e., beliefs about medicines, physician's communication skills, medication-specific social support, psychological antecedents and self-efficacy) were collected with self-report questionnaires. RESULTS: A total of 458 patients were recruited. Fischer's LSD post hoc test revealed significant differences between Italian and Polish samples in all measures (p<0.001). Multiple linear regression analysis showed low self-reported intentional non-adherence (β = -.02, p=0.031), high self-reported adherence to refill medications (β=-.05, p=0.017), high levels of perceived physician's communication effectiveness (β=0.11, p<0.001), positive beliefs about medications (β=0.13, p<0.001), and high perceived medication-specific social support (β=0.05, p<0.001) to predict significantly high patients' self-efficacy in relation to pharmacological and non-pharmacological self-reported adherence. CONCLUSION: The observed psychosocial and behavioral factors revealed to positively impact on self-efficacy in relation to treatment adherence among older chronic patients dealing with hypertension. In a prevention framework, future studies and clinical practice may consider these factors in order to improve assessment and intervention on adherence in this population.
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Zanatta et al. (2020) conducted a cross-sectional in Hypertension (n=458). Psychosocial and behavioral factors (beliefs about medications, physician's communication effectiveness, medication-specific social support) was evaluated on Patients' self-efficacy in relation to pharmacological and non-pharmacological self-reported adherence (ASonA-SE). Positive beliefs about medications, effective physician communication, and medication-specific social support significantly predicted higher self-efficacy for adherence in older hypertensive patients.
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