Psychological factors that impact on non-compliant medication use amongst patients diagnosed with hypertension

Abstract

Hypertension is defined as an asymptomatic disease which means that the disease is not related to the experience of physical symptoms. This illness is mainly managed by means of oral drug therapies, but research shows that many patients fail to take their medication as they should. Non-compliance is the main problem associated with drug-related treatments, specifically amongst patients diagnosed with chronic conditions, such as hypertension. Past research has focused on many different factors accounting for the high occurrence of non-compliance. Psychological factors relate to patients’ beliefs about their diagnosed illness and their prescribed treatment regimen. These beliefs are conceptualized in terms of the self-regulation model as constituting 5 main dimensions: identity or symptoms of their illness, the consequences of their illness, timeline or specifically referring to the course of the illness (chronic or acute), causes of the illness and controllability. Compliance is vital in the treatment and management of hypertension and research attempting to understand the relation between compliance and patients’ illness cognitions are thus important. The already high prevalence of this condition coupled with an increase in the number of people reporting low compliance suggests the need for intervention. The research question informing the present study was based on the role that psychological factors play in impacting patients’ medication-taking patterns. The medication adherence model describes medication compliance in terms of purposeful action, patterned behaviour and feedback. Purposeful action concerns patients’ intentional decisions to take their medication while patterned behaviour relates to the medication-taking patterns that patients develop. The feedback dimension guides the medication-taking patterns, providing feedback about blood pressure for example. The theory informing the present study involved social cognitive theory, which highlights the role of self-efficacy and outcome expectancies. Self-efficacy is linked with feelings of personal control and specifically refers to people’s belief in their ability to perform certain actions that will produce desired outcomes. Outcome expectancies are described as people’s ability to consider the consequences of their actions and using this information to direct their behaviour. Bearing in mind these two aspects of social cognitive theory, patients’ belief in their ability to conform to their medication instructions together with their expectations that it will improve their health will direct their medication-taking behaviour (i.e. their compliance). The illness-perception questionnaire-revised and the medication-taking questionnaire were used to obtain information about patients’ illness cognitions and their medication compliance. The correlational findings as well as the results produced by regression analysis revealed that, although illness cognitions can play a determining role in patients’ compliance, the present findings found no relation between how patients take their medication and psychological factors, defined in terms of the self-regulation model. Only one of the factors used during factor analysis revealed to significantly predict medication. Limitations associated with the present study might account for this finding and it is recommended that future research should focus on a larger sample and also use supplementary assessment measures in conjunction with self-report measures. Copyright