Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jul 1:13:1019-1035.
doi: 10.2147/PPA.S212046. eCollection 2019.

The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: a systematic review

Wejdan Shahin  1 , Gerard A Kennedy  1 , Ieva Stupans  1
Affiliations
Free PMC article
Review

The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: a systematic review

Wejdan Shahin et al. Patient Prefer Adherence. .
Free PMC article

Abstract

Background: Patients' adherence to therapeutic regimes may be influenced by subjective beliefs about chronic conditions. One of the challenges for health professionals in enhancing adherence is taking patients' understanding into account when giving health advice and/or providing medical treatment.

Purpose: This review aimed to evaluate the consequent effects of personal and cultural beliefs on medication adherence, in patients with chronic conditions such as hypertension, diabetes mellitus, chronic obstructive pulmonary disease and asthma.

Method: A systematic review methodology was used. PubMed, CINAHL, EMBASE and PsychINFO, databases were searched for relevant articles. The main terms analyzed were illness perceptions, health beliefs, cultural beliefs, chronic conditions and medication adherence.

Results: From 2,646 articles, 127 were retained for further assessment, and finally 25 met the inclusion criteria. A cross-sectional questionnaire survey research design was conducted in all included articles. Of these most (n=22) targeted hypertension or diabetes mellitus. A number of personal and cultural based factors were identified as being associated with adherence to medication regimes - 40% of articles (n=10) examined perception of illness, 20% (n=5) health literacy, 16% (n=4) cultural beliefs, 12% (n=3) self-efficacy, 16% (n=4) spiritual and religious beliefs, as well as 20% (n=5) illness knowledge. Statistically significant associations between medication adherence and these personal and cultural factors were found in 80% (n=20) of the included studies. However, the direction of associations varied between studies depending on the factor that was examined.

Conclusion: This review has evaluated the impact of personal and cultural factors on medication adherence and highlighted the gaps in literature regarding adherence. Further research is required to fully identify the associations between religious beliefs, control beliefs and illness knowledge and medication adherence.

Keywords: asthma; chronic obstructive pulmonary disease; culture; diabetes mellitus; health beliefs; hypertension; medication adherence; perception of illness.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
PRISMA flow chart of the literature search and study selection.
Figure 2
Figure 2
Conceptual model to illustrate the effect of illness perceptions and other beliefs on medication adherences. Note: Data from these studies.,
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization. Hypertension; 2018; Available from: https://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/. Accessed September25, 2018.
    1. World Health Organization. Diabetes; 2018; Available from: http://www.who.int/news-room/fact-sheets/detail/diabetes. Accessed September25, 2018.
    1. Hsiao C-Y, Chang C, Chen C-D. An investigation on illness perception and adherence among hypertensive patients. Kaohsiung J Med Sci. 2012;28(8):442–447. doi:10.1016/j.kjms.2012.02.015 - DOI - PubMed
    1. Mann DM, Ponieman D, Leventhal H, Halm EA. Predictors of adherence to diabetes medications: the role of disease and medication beliefs. J Behav Med. 2009;32(3):278–284. doi:10.1007/s10865-009-9202-y - DOI - PubMed
    1. Krauskopf K, Federman AD, Kale MS, et al. Chronic obstructive pulmonary disease illness and medication beliefs are associated with medication adherence. COPD. 2015;12(2):154–161. doi:10.3109/15412555.2014.922067 - DOI - PMC - PubMed