299 Cultural differences in illness perception and treatment adherence

Abstract

Background Patients with cystic fibrosis (CF) have a complex treatment regimen which poses emotional, social and economic burden. Adherence to treatment may be influenced by the patient's own beliefs about the disease, which in turn may be influenced by his cultural background. Objectives To examine the cultural differences in illness perception and treatment adherence, and the possible association between them. Methods A cross-sectional, single center pilot study. Thirty-three CF patients from CF center (Rappaport Children Hospital). Each patient completed the IPQ-R (illness perception-revised) questionnaire and CF-my way questionnaire to assess adherence to therapy. Illness severity was scored using CF-ABLE score. The correlations between cultural background (Jew/Non-Jew), illness perception and adherence to treatment were examined. Results 10 Jews and 23 Non-Jews, median age 21 years (range 13–49). Among the non-Jews, treatment control items were correlated with disease severity (p = 0.049) and the timeline – cyclical score was higher (12.6 vs. 8.8, p=0.002). In both groups, there was a correlation between consequences score and adherence to inhaled antibiotics and between timeline score and adherence to mucolytics. Adherence to physiotherapy was lower than recommended (p = 0.02 Jews, 0.003 non-Jews) and there were numerous misconceptions about the causes of the disease. Conclusion Non-Jews related to CF course as less predictable. Those who understood their disease had better adherence. Patients largely misunderstand the cause of CF, and tend to perform less physiotherapy than recommended. Further studies are needed to assess interventions addressing these issues.