Spiritual and religious beliefs: do they matter in the medication adherence behaviour of hypertensive patients?

BioPsychoSocial Medicine

Irene Kretchy²  Frances Owusu-Daaku³  Samuel Danquah¹ 

[1] Department of Psychology, University of Ghana, Legon, Ghana

[2] Department of Pharmacy Practice and Clinical Pharmacy, University of Ghana School of Pharmacy, College of Health Sciences, Accra, Ghana

[3] Department of Clinical and Social Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

关键词: Ghana;    Co-morbidity;    Medication non-adherence;    Religiosity;    Spirituality;   

Others  :  1082342
DOI  :  10.1186/1751-0759-7-15

 received in 2013-05-21, accepted in 2013-10-15,  发布年份 2013

【 摘 要 】

Background

Medication non-adherence is often a predominant problem in the management of hypertension and other chronic conditions. In explaining health behaviours, social determinants like spirituality and religiosity are increasingly identified to impact health and treatment. Although a number of researchers have found spirituality and religiosity to be primary resources among persons dealing with chronic disability and illness, studies relating this specifically to medication adherence have been limited.

Methods

Our study sought to examine the interrelationship between spirituality/ religiosity and medication adherence among 400 hypertensive patients 18 years old and above. Spiritual Perspective Scale, Duke Religion Index, and the Morisky Medication Adherence Scale were used to determine spirituality, religiosity and medication adherence respectively.

Results

The majority (93.25%) of patients poorly adhered to their medications. While high spiritual and religious beliefs formed core components of the lifestyles of patients, spirituality (p = 0.018) and not religiosity (p = 0.474) related directly with medication non-adherence. Likewise, after controlling for demography and other medical co-morbidities, patients with high spirituality were 2.68 times more likely to be poorly adherent than patients who place lower emphasis on the association between spirituality and health.

Conclusion

Our study suggests that while spirituality/ religiosity was dominant among hypertensive patients, these spiritual attachments of patients with a supreme being potentially increased their trust in the expectation of divine healing instead of adhering adequately with their anti-hypertensive medications.

【 授权许可】

   
2013 Kretchy et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ho MP, Bryson CL, Rumsfeld JS: Medication adherence: its importance in cardiovascular outcomes. Circulation 2009, 119:3028-3035.
• [2]Buabeng KO, Matowe L, Plange-Rhule J: Unaffordable drug prices: the major cause of non-compliance with hypertension medication in Ghana. J Pharm Pharmaceut Sci 2004, 7(3):350-352.
• [3]Agyemang C, Bruijnzeels MA, Owusu-Dabo E: Factors associated with hypertension awareness, treatment, and control in Ghana, west Africa. J Hum Hypertens 2006, 20:67-71.
• [4]Osterberg L, Blaschke T: Adherence to medication. N Engl J Med 2005, 353:487-497.
• [5]Gombojav B, Yi SW, Sull JW, Nam CM, Ohrr H: Combined effects of cognitive impairment and hypertension on total mortality in elderly people: the kangwha cohort study. Gerontology 2011, 57(6):490-496.
• [6]Redwood H: Hypertension, society, and public policy. Eur Heart J 2007, 9:B13-B18.
• [7]Penman J, Oliver M, Harrington A: Spirituality and spiritual engagement as perceived by palliative care clients and caregivers. Aust J Adv Nurs 2009, 26(4):29-35.
• [8]Kudel I, Cotton S, Szaflarski M, Holmes WC, Tsevat J: Spirituality and religiosity in patients with HIV: a test and expansion of a model. Ann Behav Med 2011, 41(1):92-103.
• [9]Miller WR, Thoresen CE: Spirituality, religion, and health. Am Psychol 2003, 58:24-35.
• [10]Mohr WK: Spiritual issues in psychiatric care. Perspect Psychiatr Care 2006, 42:174-183.
• [11]Koenig HG, McCullough ME, Larson DB: Handbook of religion and health. Oxford: Oxford University Press; 2001.
• [12]Pearce MJ, Little TD, Perez JE: Religiousness and depressive symptoms among adolescents. J Clin Child Adolesc Psychol 2003, 32(2):267-276.
• [13]McDade R: A mixed method study of spirituality and the influence on TB medication adherence. In Proceedings of the sixth annual college of education research conference: 2007: urban and international education section. Edited by Nielsen SM, Plakhotnik MS. Miami, Florida: International University; 54-59.
• [14]Armstrong TD, Crowther MR: Spirituality among older African-Americans. J Adult Dev 2002, 9(1):3-12.
• [15]Campbell JD, Yoon DP, Johnstone B: Determining relationships between physical health and spiritual experience, religious practices, and congregational support in a heterogeneous medical sample. J Relig Health 2010, 49:3-17.
• [16]Hackney CL, Sanders GS: Religiosity and mental health: a meta-analysis of recent studies. J Sci Study Relig 2003, 42:43-55.
• [17]Hall DE, Meador KG, Koenig HG: Measuring religiousness in health research: review and critique. J Relig Health 2008, 47(2):134-163.
• [18]Levin J: “And let us make us a name”: reflections on the future of the religion and health field. J Relig Health 2009, 48:125-145.
• [19]Buck AC, Williams DR, Musick MA, Sternthal MJ: An examination of the relationship between multiple dimensions of religiosity, blood pressure, and hypertension. Soc Sci Med 2009, 68(2):314-322.
• [20]Gillum RF, Ingram DD: Frequency of attendance at religious services, hypertension, and blood pressure: the third national health and nutrition examination survey. Psychosom Med 2006, 68(3):382-385.
• [21]Hummer RA, Ellison CG, Rogers RG, Moulton BE, Romero RR: Religious involvement and adult mortality in the United States: review and perspective. South Med J 2004, 97:1223-1230.
• [22]Koenig HG: Religion, spirituality, and medicine: research findings and implications for clinical practice. South Med J 2004, 97:1194-1200.
• [23]Clay KS, Talley C, Young KB: Exploring spiritual well-being among survivors of colorectal and lung cancer. J Relig Spiritual Soc Work 2010, 29(1):14-32.
• [24]Powell LH, Shahabi L, Thoresen CE: Religion and spirituality. Linkages to physical health. Am Psychol 2003, 58(1):36-52.
• [25]Riegel B, Moser DK, Anker SD, Appel LJ, Dunbar SB, et al.: State of the science: promoting self-care in persons with heart failure: a scientific statement from the American heart association. Circulation 2009, 120(12):1141-1163.
• [26]Westlake C, Dracup K, Creaser J, Livingston N, Heywood JT, et al.: Correlates of health-related quality of life in patients with heart failure. Heart Lung 2002, 31(2):85-93.
• [27]Beery TA, Baas LS, Fowler C, Allen G: Spirituality in persons with heartfailure. J Holist Nurs 2002, 20(1):5-25.
• [28]Erah PO, Arute JE: Adherence of HIV/AIDS patients to antiretroviral therapy in a tertiary health facility in Benin City. Afr J Pharm Pharmacol 2008, 2(7):145-152.
• [29]Jesse DE, Reed RG: Effects of spirituality and psychosocial well-being on health risk behaviors in Appalachian pregnant women. J Obstet, Gynecolo, and Neonatal Nurs 2004, 33:739-747.
• [30]Fetzer Institute, National Institute on Aging Working Group: Multidimensional measurement of religiousness/ spirituality for use in health research. Kalamazoo: Fetzer Institute; 2003.
• [31]Ross S, Walker A, MacLeod MJ: Patient compliance in hypertension: role of illness perceptions and treatment beliefs. J Hum Hypertens 2004, 18:607-613.
• [32]Morisky DE, Ang A, Krousel-Wood M, Ward HJ: Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens 2008, 10(5):348-354.
• [33]Simoni JM, Frick PA, Huang B: A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy. Health Psychol 2006, 25(1):74-81.
• [34]Raghavan R, Ferlic-Stark L, Clarke C, Rungta M, Goodgame R: The role of patient religiosity in the evaluation and treatment outcomes for chronic HCV Infection. J Rel Health 2013, 52:79-90.
• [35]Wanyama J, Castelnuovo B, Wandera B, Mwebaze P, Kambugu A, Bandsberg DR, et al.: Belief in divine healing can be a barrier to antiretroviral therapy adherence in Uganda. AIDS 2007, 21(11):1486-1487.
• [36]Johnstone B, Franklin KL, Yoon DP, Burris J, Shigaki C: Relationships among religiousness, spirituality, and health for individuals with stroke. J Clin Psychol Med Settings 2008, 15:308-313.
• [37]de-Graft Aikins A, Anum A, Agyemang C, Addo J, Ogedegbe O: Lay representations of chronic diseases in Ghana: implications for primary prevention. Ghana Med J 2012, 46(2):59-68.
• [38]Read U: “I want the one that will heal me completely so it won’t come back again”: the limits of antipsychotic medication in rural Ghana. Transcult Psychiatry 2012, 49(3–4):438-460.