Abstract
Older adults suffering from hypertension form firm medication beliefs through lifetime medication management, which significantly affect their medication adherence and treatment outcomes. Understanding whether the patient-physician communication has the potential to change medication beliefs will help design an effective communication strategy to foster favorable medication beliefs. This study aims to determine whether the patient-physician communication is associated with medication beliefs among older adults with hypertension and controls socio-demographics and clinical characteristics. Further, it examines how the association varies with two different types of medication beliefs (medication overuse and harm) for each domain of communication (informative and interpersonal). A self-administered cross-sectional survey was conducted for members of seven senior centers in a metropolitan area of the United States between August and December of 2013. A total of 211 senior members suffering from hypertension completed the questionnaire, which included the Primary Care Assessment Survey (PCAS) and the Beliefs about Medicines Questionnaire (BMQ). The former had two domains of patient-physician communication—informative and interpersonal—while the latter measured medication harm and overuse beliefs. Interpersonal patient-physician communication significantly explained the medication overuse beliefs (β = -0.28, p < 0.05), whereas neither interpersonal nor informative communication significantly explained the medication harm beliefs. Females (β = 1.29, p < 0.01) and participants with higher education (β = 2.66, p = 0.02) more strongly believed that medications are overprescribed. However, participants with low income more strongly believed that medications are harmful. Patient-physician communication, if it touches upon interpersonal aspects, has the potential to change medication overuse beliefs among older adults with hypertension. Identification of the significant factors which affect medication beliefs, will inform the design of a patient-centric communication program that fosters favorable medication beliefs among geriatric hypertensive patients.
Highlights
Medication beliefs are known to affect medication adherence [1,2,3,4], an essential behavioral change required for successful treatment outcomes [5,6,7]
The study participants had suffered from hypertension for a period of 11.6 years (SD = 8.5) with one-third (38.9%) having a comorbidity of 0 in Charlson Comorbidity Index (CCI), and 31.8% CCI having a comorbidity of 2
This study found that among the two types of medication beliefs, only the medication overuse belief was significantly explained by patient-physician communication that pertained to the interpersonal domain
Summary
Medication beliefs are known to affect medication adherence [1,2,3,4], an essential behavioral change required for successful treatment outcomes [5,6,7]. Physicians should think about ways to improve medication beliefs, as recommended by the good medical practice guidelines of the General Medical Council (GMC) in the United Kingdom [8]. It especially applies for chronic conditions such as hypertension, whose treatment requires long-term medication therapy. Many studies report that medication beliefs significantly affect medication adherence [10,11,12,13]. There is a critical need to identify the factors which are associated with medication beliefs Identifying those factors can inform the design of effective strategies to improve medication beliefs for the purpose of better medication adherence
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