BackgroundCurrent health policies emphasize the need for an equitable doctor-patient relationship, and this requires a certain level of patient empowerment. However, a systematic review of the empirical evidence on how empowerment affects medication adherence—the extent to which patients follow the physician’s prescription of medication intake—is still missing. The goal of this systematic review is to sum up current state-of-the-art knowledge concerning the relationship between patient empowerment and medication adherence across medical conditions. As our conceptualization defines health locus of control and self-efficacy as being crucial components of empowerment, we explored the relationship between these two constructs and medication adherence.MethodsRelevant studies were retrieved through a comprehensive search of Medline and PsychINFO databases (1967 to 2017). In total, 4903 publications were identified. After applying inclusion and exclusion criteria and quality assessment, 154 articles were deemed relevant. Peer-reviewed articles, written in English, addressing the relationship between empowerment (predictor) and medication adherence (outcome) were included.FindingsHigh levels of self-efficacy and Internal Health Locus of Control are consistently found to promote medication adherence. External control dimensions were found to have mainly negative (Chance and God attributed control beliefs) or ambiguous (Powerful others attributed control beliefs) links to adherence, except for Doctor Health Locus of Control which had a positive association with medication adherence. To fully capture how health locus of control dimensions influence medication adherence, the interaction between the sub-dimensions and the attitudinal symmetry between the doctor and patient, regarding the patient’s control over the disease management, can provide promising new alternatives.DiscussionThe beneficial effect of patients’ high internal and concurrent physician-attributed control beliefs suggests that a so-called “joint empowerment” approach can be suitable in order to foster medication adherence, enabling us to address the question of control as a versatile component in the doctor-patient relationship.
BackgroundMedication non-adherence is a major public health issue, creating obstacles to effective treatment of hypertension. Examining the underlying factors of deliberate and non-deliberate non-adherence is crucial to address this problem. Thus, the goal of the present study is to assess the socio-demographic, clinical and psychological determinants of intentional and unintentional non-adherence.Design and methodsA cross-sectional survey was conducted between March, 2015 and April, 2016. The sample consisted of hypertension patients holding at least one medical prescription (N=109). Measurements assessed patients’ medication adherence, health literacy, empowerment, self-efficacy, medication beliefs, and patients’ acceptance of their doctor’s advice, socio-demographic and clinical characteristics.ResultsPatients who occasionally engaged in either intentional or unintentional non-adherence reported to have lower adherence selfefficacy, higher medication concern beliefs, lower meaningfulness scores and were less likely to accept the doctor’s treatment recommendations. Patients who occasionally engaged in unintentional nonadherence were younger and had experienced more side effects compared to completely adherent patients. Adherence self-efficacy was a mediator of the effect of health literacy on patients’ medication adherence and acceptance of the doctor’s advice was a covariate.ConclusionsRegarding the research implications, health literacy and adherence self-efficacy should be assessed simultaneously when investigating the factors of non-adherence. Regarding the practical implications, adherence could be increased if physicians i) doublecheck whether their patients accept the treatment advice given and ii) if they address patients’ concerns about medications. These steps could be especially important for patients characterized with lower self-efficacy, as they are more likely to engage in occasional nonadherence.Significance for public healthMedication non-adherence is a critical public health issue, leading to increased health care costs, morbidity and mortality across several chronic conditions. Medication non-adherence is also one of the main obstacles to effective hypertension care, as between 20-50% of the patients do not follow appropriately their prescribed medication regimen. Despite the large body of empirical evidence available, relatively little is known about the potential differences between the determinants underpinning intentional versus unintentional nonadherence. Shedding light on the factors of medication non-adherence is inevitable to develop interventions and health campaigns addressing the issue. Thus, the present study quantitatively examines the patient-related factors of medication non-adherence to antihypertensive drugs, distinguishing between the determinants of deliberate versus non-deliberate non-adherence. Moreover, based on the outcomes, we advocate potential new approaches to address medication non-adherence in hypertension.
Bevezetés: A gyógyítás sikerességét meghatározza, hogy a beteg érti-e és megfelelően használja-e az orvosi informáci-ókat. Ezt jelentős mértékben befolyásolja az úgynevezett "health literacy" (egészségműveltség). Célkitűzés: A tanulmány az egyik legelterjedtebb funkcionális egészségműveltséget mérő eszköz, a Short-Test of Functional Health Literacy, valamint egy előszűrő teszt (Chew-kérdések) magyar adaptációját mutatja be. Módszer: 302 fős felnőttmin-tán vették fel a célkérdőívet egy nagyobb tesztbattéria részeként, amelyben szerepelt a számolási készségeket mérő Newest Vital Sign teszt is. Eredmények: A Short-Test of Functional Health Literacy olvasott szövegértési rész belső konzisztenciája kimagaslóan jó, a Chew-kérdéseké elfogadható, a számolási részé azonban alacsony megbízhatóságú. A célkérdőív egészségműveltségi szintjeinek magyar eloszlása illeszkedik más európai felmérések adataihoz. A problémás egészségműveltség kategóriába kerülésre a 65 év felettiek és az általános iskolai végzettségűek voltak különösen veszélyeztetettek. A krónikus betegség alacsonyabb egészségműveltséggel jár együtt, ami egybevág más európai eredményekkel. Következtetések: A szerzők által validált mérőeszközök segíthetik a problémás páciensek kiszűrését, a hatékonyabb információmegértést és -felhasználást. Orv. Hetil., 2016, 157(23), 905-915. Kulcsszavak: egészségműveltség, tesztvalidálás, egészségfejlesztés "So each patient comprehends": measuring health literacy in HungaryInroduction: The efficiency of healing is determined by the ability of the patients to comprehend and to apply properly the information provided by the doctors. This ability is influenced by age, intelligence and social background, but above all by health literacy. Aim: The aim of the present study was to translate and adapt the Hungarian version of the Short-Test of Functional Health Literacy, which is a performance based measure and the perception-based Chew screening questions for health literacy in Hungary. Method: The sample consisted of 302 people, and it was closely representative for the Hungarian population. Results: The reliability of the reading part of the Short-Test of Functional Health Literacy was excellent, and it was also acceptable regarding the Chew screening questions, but it showed low internal consistency concerning the numeracy part of the Short-Test of Functional Health Literacy. Based on the Short-Test of Functional Health Literacy reading scores, participants were categorized into three groups: 8% had inadequate, 6% marginal and 86% adequate health literacy levels. Regarding participants without a chronic illness tended to possess higher health literacy levels based on all the three measurments. Conclusions: The availability of these measures of health literacy in Hungary can play a crucial role in doctor-patient communication as well as health promotion, that can contribute to develop health literacy policies leading to reduced health care costs in the future.
A doctor-patient relationship following the precepts of the patient-centered care is a significant resource that can lead to increased patient resilience. Thus, future interventions promoting patient resilience might consider addressing the doctor-patient relationship.
Bevezetés: A gyógyítás sikerességét meghatározza, hogy a beteg érti-e és megfelelően használja-e az orvosi informáci-ókat. Ezt jelentős mértékben befolyásolja az úgynevezett "health literacy" (egészségműveltség). Célkitűzés: A tanulmány az egyik legelterjedtebb funkcionális egészségműveltséget mérő eszköz, a Short-Test of Functional Health Literacy, valamint egy előszűrő teszt (Chew-kérdések) magyar adaptációját mutatja be. Módszer: 302 fős felnőttmin-tán vették fel a célkérdőívet egy nagyobb tesztbattéria részeként, amelyben szerepelt a számolási készségeket mérő Newest Vital Sign teszt is. Eredmények: A Short-Test of Functional Health Literacy olvasott szövegértési rész belső konzisztenciája kimagaslóan jó, a Chew-kérdéseké elfogadható, a számolási részé azonban alacsony megbízhatóságú. A célkérdőív egészségműveltségi szintjeinek magyar eloszlása illeszkedik más európai felmérések adataihoz. A problémás egészségműveltség kategóriába kerülésre a 65 év felettiek és az általános iskolai végzettségűek voltak különösen veszélyeztetettek. A krónikus betegség alacsonyabb egészségműveltséggel jár együtt, ami egybevág más európai eredményekkel. Következtetések: A szerzők által validált mérőeszközök segíthetik a problémás páciensek kiszűrését, a hatékonyabb információmegértést és -felhasználást. Orv. Hetil., 2016, 157(23), 905-915. Kulcsszavak: egészségműveltség, tesztvalidálás, egészségfejlesztés "So each patient comprehends": measuring health literacy in HungaryInroduction: The efficiency of healing is determined by the ability of the patients to comprehend and to apply properly the information provided by the doctors. This ability is influenced by age, intelligence and social background, but above all by health literacy. Aim: The aim of the present study was to translate and adapt the Hungarian version of the Short-Test of Functional Health Literacy, which is a performance based measure and the perception-based Chew screening questions for health literacy in Hungary. Method: The sample consisted of 302 people, and it was closely representative for the Hungarian population. Results: The reliability of the reading part of the Short-Test of Functional Health Literacy was excellent, and it was also acceptable regarding the Chew screening questions, but it showed low internal consistency concerning the numeracy part of the Short-Test of Functional Health Literacy. Based on the Short-Test of Functional Health Literacy reading scores, participants were categorized into three groups: 8% had inadequate, 6% marginal and 86% adequate health literacy levels. Regarding participants without a chronic illness tended to possess higher health literacy levels based on all the three measurments. Conclusions: The availability of these measures of health literacy in Hungary can play a crucial role in doctor-patient communication as well as health promotion, that can contribute to develop health literacy policies leading to reduced health care costs in the future.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.