The consequences of general medication beliefs measured by the Beliefs about Medicine Questionnaire on medication adherence : A systematic review
- Shahin, Wejdan, Kennedy, Gerard, Stupans, Ieva
- Authors: Shahin, Wejdan , Kennedy, Gerard , Stupans, Ieva
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Pharmacy Vol. 8, no. 3 (2020), p. 1-15
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- Description: (1) Background: Medication adherence is a key determinant of patient health outcomes in chronic illnesses. However, adherence to long-term therapy remains poor. General beliefs about medicine are considered factors influencing medication adherence. It is essential to address the gap in the literature regarding understanding the impact of general beliefs about medicine on medication adherence to promote adherence in chronic illnesses. (2) Methods: PubMed, CINHAL, and EMBASE databases were searched. Studies were included if they examined medication beliefs using the Beliefs about Medicine Questionnaire in one of four chronic illnesses: hypertension, diabetes, chronic obstructive pulmonary disease, and/or asthma. (3) Results: From 1799 articles obtained by the search, only 11 met the inclusion criteria. Hypertension and diabetes represented 91% of included studies, while asthma represented 9%. Higher medication adherence was associated with negative general medication beliefs; 65% of the included studies found a negative association between harm beliefs and adherence, while 30% of studies found a negative association with overuse beliefs. (4) Conclusions: This review evaluated the impact of harm and overuse beliefs about medicines on medication adherence, highlighting the gap in literature regarding the impact of harm and overuse beliefs on adherence. Further research is needed to fully identify the association between general beliefs and medication adherence in people with different cultural backgrounds, and to explore these beliefs in patients diagnosed with chronic illnesses, particularly asthma and chronic obstructive pulmonary disease (COPD). Healthcare providers need to be aware of the impact of patients' cultural backgrounds on general medication beliefs and adherence.
- Authors: Shahin, Wejdan , Kennedy, Gerard , Stupans, Ieva
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Pharmacy Vol. 8, no. 3 (2020), p. 1-15
- Full Text:
- Reviewed:
- Description: (1) Background: Medication adherence is a key determinant of patient health outcomes in chronic illnesses. However, adherence to long-term therapy remains poor. General beliefs about medicine are considered factors influencing medication adherence. It is essential to address the gap in the literature regarding understanding the impact of general beliefs about medicine on medication adherence to promote adherence in chronic illnesses. (2) Methods: PubMed, CINHAL, and EMBASE databases were searched. Studies were included if they examined medication beliefs using the Beliefs about Medicine Questionnaire in one of four chronic illnesses: hypertension, diabetes, chronic obstructive pulmonary disease, and/or asthma. (3) Results: From 1799 articles obtained by the search, only 11 met the inclusion criteria. Hypertension and diabetes represented 91% of included studies, while asthma represented 9%. Higher medication adherence was associated with negative general medication beliefs; 65% of the included studies found a negative association between harm beliefs and adherence, while 30% of studies found a negative association with overuse beliefs. (4) Conclusions: This review evaluated the impact of harm and overuse beliefs about medicines on medication adherence, highlighting the gap in literature regarding the impact of harm and overuse beliefs on adherence. Further research is needed to fully identify the association between general beliefs and medication adherence in people with different cultural backgrounds, and to explore these beliefs in patients diagnosed with chronic illnesses, particularly asthma and chronic obstructive pulmonary disease (COPD). Healthcare providers need to be aware of the impact of patients' cultural backgrounds on general medication beliefs and adherence.
The effect of acculturation and harm beliefs on medication adherence on Middle Eastern hypertensive refugees and migrants in Australia
- Shahin, Wejdan, Kennedy, Gerard, Cockshaw, Wendell, Stupans, Ieva
- Authors: Shahin, Wejdan , Kennedy, Gerard , Cockshaw, Wendell , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Clinical Pharmacy Vol. 43, no. 5 (2021), p. 1283-1292
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- Description: Background Different populations have different levels of acculturation, and beliefs about medications. Little is known about the differences between refugees and migrants regarding these various beliefs. Adherence to medications is influenced by many factors, including individuals’ characteristics, acculturation, and their perceptions about medications. Having a thorough understanding of these beliefs contributes to understanding medication adherence in refugee and migrant populations. Objectives To evaluate the differences between Middle Eastern refugees and migrants in Australia regarding acculturation, beliefs about medications, and medication adherence, and to evaluate the association of acculturation and beliefs about medications and natural remedies with medication adherence. Setting Participants were recruited from various community groups and English language learning centres in Australia. Arabic Facebook community groups were also used to recruit participants for this study. Method A total of 320 Middle Eastern refugees and migrants with hypertension completed Arabic or English versions of the general Beliefs about Medicine Questionnaire (BMQ)—harm scale, a question about beliefs in natural remedies, six items about acculturation and the Medication Adherence Questionnaire. Two models of multiple mediation were applied. The first model examined the role of acculturation, length of residency, beliefs about natural remedies, and harm beliefs as mediators between migration status and medication adherence. The second model identified the role of acculturation, and beliefs about natural remedies as mediators between migration status and medication harm beliefs. Main outcome measure Medication adherence, harm beliefs about medication, acculturation, and beliefs about natural remedies. In addition, the differences between refugees and migrants regarding these beliefs and medication adherence. Results Differences were found between refugees and migrants for medication adherence and medication beliefs. Refugees were likely to have more harm beliefs towards medicine and were less acculturated than migrants (p = 0.0001). They were also less likely to adhere to medications (p = 0.0001), and perceived natural remedies to be safer than Western medications (p = 0.0001). Perceiving medications as harmful substances, and beliefs in natural remedies were mediators in the relationship between migration status and medication adherence. Beliefs in natural remedies and acculturation were mediators in the relationship between migration status and harm beliefs. Conclusion Beliefs about medications and natural remedies, and acculturation in refugees and migrants need to be better understood to enhance medication adherence and potentially overall health outcomes. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.
- Authors: Shahin, Wejdan , Kennedy, Gerard , Cockshaw, Wendell , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Clinical Pharmacy Vol. 43, no. 5 (2021), p. 1283-1292
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- Description: Background Different populations have different levels of acculturation, and beliefs about medications. Little is known about the differences between refugees and migrants regarding these various beliefs. Adherence to medications is influenced by many factors, including individuals’ characteristics, acculturation, and their perceptions about medications. Having a thorough understanding of these beliefs contributes to understanding medication adherence in refugee and migrant populations. Objectives To evaluate the differences between Middle Eastern refugees and migrants in Australia regarding acculturation, beliefs about medications, and medication adherence, and to evaluate the association of acculturation and beliefs about medications and natural remedies with medication adherence. Setting Participants were recruited from various community groups and English language learning centres in Australia. Arabic Facebook community groups were also used to recruit participants for this study. Method A total of 320 Middle Eastern refugees and migrants with hypertension completed Arabic or English versions of the general Beliefs about Medicine Questionnaire (BMQ)—harm scale, a question about beliefs in natural remedies, six items about acculturation and the Medication Adherence Questionnaire. Two models of multiple mediation were applied. The first model examined the role of acculturation, length of residency, beliefs about natural remedies, and harm beliefs as mediators between migration status and medication adherence. The second model identified the role of acculturation, and beliefs about natural remedies as mediators between migration status and medication harm beliefs. Main outcome measure Medication adherence, harm beliefs about medication, acculturation, and beliefs about natural remedies. In addition, the differences between refugees and migrants regarding these beliefs and medication adherence. Results Differences were found between refugees and migrants for medication adherence and medication beliefs. Refugees were likely to have more harm beliefs towards medicine and were less acculturated than migrants (p = 0.0001). They were also less likely to adhere to medications (p = 0.0001), and perceived natural remedies to be safer than Western medications (p = 0.0001). Perceiving medications as harmful substances, and beliefs in natural remedies were mediators in the relationship between migration status and medication adherence. Beliefs in natural remedies and acculturation were mediators in the relationship between migration status and harm beliefs. Conclusion Beliefs about medications and natural remedies, and acculturation in refugees and migrants need to be better understood to enhance medication adherence and potentially overall health outcomes. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.
A qualitative exploration of the impact of knowledge and perceptions about hypertension in medication adherence in Middle Eastern refugees and migrants
- Shahin, Wejdan, Kennedy, Gerard, Stupans, Ieva
- Authors: Shahin, Wejdan , Kennedy, Gerard , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: Exploratory Research in Clinical and Social Pharmacy Vol. 3, no. (2021), p. 100038-100038
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- Description: Knowledge and perceptions about chronic disease and medications play a crucial role in determining long-term treatment adherence to diseases such as hypertension. Exploring in depth the barriers and enablers to medication adherence in specific population subgroups such as Middle Eastern refugees and migrants in Australia is important. This may provide a better understanding of each of these groups' beliefs and knowledge and suggest strategies and interventions to improve medication adherence. This study aimed to understand Middle Eastern refugees' and migrants' experiences, perceptions, and knowledge about hypertension and to explore factors affecting medication adherence. In this study 15 participants who identified themselves as Middle Eastern refugees and migrants in Australia and had been diagnosed with hypertension were interviewed (migrants = 5, refugees =10) using semi-structured interviews. Recorded interviews were analysed using a thematic analysis framework and the findings were reported according to consolidated criteria for reporting qualitative research. Three key themes emerged from the interview analysis: (1) dealing with the illness in terms of understanding the symptoms and causes, self-managing of high blood pressure, and coping and acquaintance with the illness (2) beliefs, practices around medication adherence and the barriers and facilitators to taking medications regularly and (3) healthcare encounters represented by participants trust in healthcare providers. Differences were found between refugees and migrants relating to the understanding, control, and coping with hypertension, beliefs about medications, trust of healthcare providers, and taking medications as prescribed. There were also differences in the social context of the two groups. Understanding the factors that prevent adherence to hypertension in Middle Eastern refugees addressed the gap in the literature regarding refugees' beliefs and medication adherence. Future studies are recommended to assess the improvement in medication adherence in refugees by modifying their beliefs, attitude, and knowledge about medications and illness. In addition, healthcare providers should consider the differences between Middle Eastern refugees and migrants when providing the health advice that targets each of these population independently to ultimately improve their overall health and adherence to medications. Erratum: The publisher regrets that the section below was accidentally anonymized in the original published version of this article: “Ethical approval was obtained from (redacted) 60–19/22299”. This section should read: “Ethical approval was obtained from RMIT University Ethics Committee 60–19/22299”. The publisher would like to apologise for any inconvenience caused.
- Authors: Shahin, Wejdan , Kennedy, Gerard , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: Exploratory Research in Clinical and Social Pharmacy Vol. 3, no. (2021), p. 100038-100038
- Full Text:
- Reviewed:
- Description: Knowledge and perceptions about chronic disease and medications play a crucial role in determining long-term treatment adherence to diseases such as hypertension. Exploring in depth the barriers and enablers to medication adherence in specific population subgroups such as Middle Eastern refugees and migrants in Australia is important. This may provide a better understanding of each of these groups' beliefs and knowledge and suggest strategies and interventions to improve medication adherence. This study aimed to understand Middle Eastern refugees' and migrants' experiences, perceptions, and knowledge about hypertension and to explore factors affecting medication adherence. In this study 15 participants who identified themselves as Middle Eastern refugees and migrants in Australia and had been diagnosed with hypertension were interviewed (migrants = 5, refugees =10) using semi-structured interviews. Recorded interviews were analysed using a thematic analysis framework and the findings were reported according to consolidated criteria for reporting qualitative research. Three key themes emerged from the interview analysis: (1) dealing with the illness in terms of understanding the symptoms and causes, self-managing of high blood pressure, and coping and acquaintance with the illness (2) beliefs, practices around medication adherence and the barriers and facilitators to taking medications regularly and (3) healthcare encounters represented by participants trust in healthcare providers. Differences were found between refugees and migrants relating to the understanding, control, and coping with hypertension, beliefs about medications, trust of healthcare providers, and taking medications as prescribed. There were also differences in the social context of the two groups. Understanding the factors that prevent adherence to hypertension in Middle Eastern refugees addressed the gap in the literature regarding refugees' beliefs and medication adherence. Future studies are recommended to assess the improvement in medication adherence in refugees by modifying their beliefs, attitude, and knowledge about medications and illness. In addition, healthcare providers should consider the differences between Middle Eastern refugees and migrants when providing the health advice that targets each of these population independently to ultimately improve their overall health and adherence to medications. Erratum: The publisher regrets that the section below was accidentally anonymized in the original published version of this article: “Ethical approval was obtained from (redacted) 60–19/22299”. This section should read: “Ethical approval was obtained from RMIT University Ethics Committee 60–19/22299”. The publisher would like to apologise for any inconvenience caused.
- Singh, Harjit, Kennedy, Gerard, Stupans, Ieva
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2022
- Type: Text , Journal article
- Relation: Health Promotion Journal of Australia Vol. 33, no. 2 (2022), p. 480-487
- Full Text: false
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- Description: Issue addressed: Australian pharmacists are increasingly moving towards the provision of patient-centred professional pharmacy services for chronic disease management. Some of these services are targeted towards improving patients’ health and wellbeing through the facilitation of patient-driven health behaviour change. This paper investigates whether the provision of behaviour change interventions by Australian pharmacists is adequately underpinned by the current competency framework. Methods: The foundation and behaviour change competences within each of the domains in the generic health behaviour change competency framework (GHBC-CF), was mapped to the Australian pharmacist competency framework. Results: Although the Australian competency framework underpins most of the foundation and behaviour change competences of the GHB-CF required to undertake low-intensity interventions, for medium to high-intensity interventions four specific task-related competences need to be addressed. These are F12 ‘Ability to recognise barriers to and facilitators of implementing interventions’, BC4 ‘ability to agree on goals for the intervention’, BC5 ‘capacity to implement behaviour change models in a flexible but coherent manner’ and BC6 ‘capacity to select and skilfully apply most appropriate intervention method’. Conclusion: Additional training is necessary if pharmacists aspire to provide behaviour change interventions for chronic disease management, in particular those that are complex as they involve changes to multiple health behaviours. So what?: The identification of these gaps is critical and can potentially be addressed in postgraduate training programs and as pharmacy curricula are updated. © 2021 Australian Health Promotion Association.
Competencies and training of health professionals engaged in health coaching : a systematic review
- Singh, Harjit, Kennedy, Gerard, Stupans, Ieva
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2022
- Type: Text , Journal article
- Relation: Chronic Illness Vol. 18, no. 1 (2022), p. 58-85
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- Description: Objective: A systematic review was undertaken in order to evaluate the competencies of primary healthcare professionals who are engaged with health coaching patients with chronic health conditions. Methods: The databases CINHAL, EMBASE, PubMed, PsychINFO and SCOPUS were searched to identify peer reviewed papers referring to competencies of health professionals engaged in health coaching. Results: Nine key competencies that health professionals met and which resulted in successful patient outcomes from health coaching were identified. Comparisons of the core health coaching competencies to the competencies for coaches established by the International Coaching Federation and European Mentoring and Coaching Council showed considerable overlap. However, the comparison also reiterated the need for competencies specific to health coaches to be made explicit. Discussion: Health coaching has been shown to improve the health outcomes in patients with chronic health conditions. As such, there is a need to build an evidenced-based competency framework specific to health coaches. At present, the lack of a competency framework on which to base health coach training could significantly impact the outcomes of patients receiving health coaching. Practical implications include improving regulation and quality of health coaching, and more importantly, the health outcomes of patients receiving the service. © The Author(s) 2020.
The association between social support and medication adherence in patients with hypertension : a systematic review
- Shahin, Wejdan, Kennedy, Gerard, Stupans, Ieva
- Authors: Shahin, Wejdan , Kennedy, Gerard , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: Pharmacy Practice Vol. 19, no. 2 (2021), p.
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- Description: Background: Medication adherence is a primary determinant of treatment success in hypertensive patients. One of the challenges for healthcare providers that has received little attention is the impact of patients’ social supports on medication adherence. Objective: This review evaluates the impact of patients’ social supports on medication adherence in hypertensive patients. Methods: A systematic review methodology was used. Pubmed, CINAHL, Embase, and PsycINFO databases were searched systematically for relevant articles. The outcome measure in the studies was medication adherence in hypertension. Results: From 1155 articles, 238 were retained for further assessment, and finally, 14 met the inclusion criteria. Statistically significant positive associations between medication adherence and social support were found in nine studies (p<0.05). Conclusions: This review evaluated the impact of social support on medication adherence and highlighted gaps in the literature regarding the impact of social support on adherence. Family members or peer support may promote better adherence in some patient groups. This review suggests that healthcare providers may need to consider whether patients have appropriate social supports in place which will assist them adhering to and benefiting from treatment recommendations. © the Authors.
- Authors: Shahin, Wejdan , Kennedy, Gerard , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: Pharmacy Practice Vol. 19, no. 2 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Medication adherence is a primary determinant of treatment success in hypertensive patients. One of the challenges for healthcare providers that has received little attention is the impact of patients’ social supports on medication adherence. Objective: This review evaluates the impact of patients’ social supports on medication adherence in hypertensive patients. Methods: A systematic review methodology was used. Pubmed, CINAHL, Embase, and PsycINFO databases were searched systematically for relevant articles. The outcome measure in the studies was medication adherence in hypertension. Results: From 1155 articles, 238 were retained for further assessment, and finally, 14 met the inclusion criteria. Statistically significant positive associations between medication adherence and social support were found in nine studies (p<0.05). Conclusions: This review evaluated the impact of social support on medication adherence and highlighted gaps in the literature regarding the impact of social support on adherence. Family members or peer support may promote better adherence in some patient groups. This review suggests that healthcare providers may need to consider whether patients have appropriate social supports in place which will assist them adhering to and benefiting from treatment recommendations. © the Authors.
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