<p>The Role of Medication Beliefs on Medication Adherence in Middle Eastern Refugees and Migrants Diagnosed with Hypertension in Australia</p>

Abstract

Purpose The study assessed the association between medication beliefs and adherence in Middle Eastern refugees and migrants in Australia, and also examined differences between the two groups regarding beliefs and adherence to medication. Patients and Methods A total of 319 Middle Eastern refugees and migrants with hypertension were approached via various social groups in Australia and asked to complete Arabic versions of the Beliefs about Medicine Questionnaire (BMQ) and the Medication Adherence Questionnaire. BMQ scores (necessity and concerns scales) were classified as “accepting”, “indifferent”, “ambivalent” or “skeptical”. Multiple mediation modelling was applied to examine the role of necessity and concerns scales as mediators between migration status and medication adherence. Results There were significant associations between medication adherence and medication beliefs scores (necessity and concerns scales) ( p =0.0001). Necessity and concern were mediators in the relationship between migration status and medication adherence. Significant differences were found between refugees and migrants for medication adherence and medication beliefs. Refugees were likely to have less necessity, and more concern beliefs than migrants, and were also less likely to adhere to medications. Almost 30% of refugees could be classified as skeptical and 40% as ambivalent. In contrast, 50% of migrants had accepting beliefs, and around 35% held ambivalent beliefs. Refugees and migrants with “accepting” beliefs reported the highest adherence to medication and those holding “skeptical” beliefs reported the lowest adherence. Conclusion Medication beliefs are potentially modifiable and are reasonable targets for clinical interventions designed to improve medication adherence. Understanding these beliefs and the likely differences between refugees and migrants is crucial to provide specific and targeted advice to each group independently in order to improve medication adherence and overall health.

Factors Associated with Suboptimal Adherence to Hypertensive Medications Among Syrian Refugees – Cross-Sectional Study at the Zaatari Camp, Jordan

“…A recent comparative study in Australia showed that hypertensive Middle Eastern refugees, including Syrians, had more concerns about the side effects of hypertension treatment than migrants who had consciously left their country and were less exposed to the circumstances associated with displacement, which in turn led to significantly low adherence rates in the refugee group. 30 Considering that subjective perceptions and beliefs may determine a person’s health behaviours, 31 it is recommended that future studies assess the impact of this factor on adherence levels among syrians in Jordan by using multidimensional scales that account for the complexity of human perceptions and beliefs. Also, it is recommended to use mixed-methods research approaches involving quantitative and qualitative methods, as the former provides valuable information on persistence but is less precise in examining perceptual aspects.…”

A qualitative exploration of the impact of knowledge and perceptions about hypertension in medication adherence in Middle Eastern refugees and migrants

“…The findings of these studies suggest that the reasons behind the differences in medication adherence contribute to refugees' and migrants' differing perceptions of illness, culture and medications. 20 , 28 Research highlights the need for patient-centred interventions and processes to improve medication adherence. 22 Therefore, understanding these beliefs, and the differences between the two groups regarding their perceptions is crucial for developing interventions oriented towards better adherence to prescribed medications.…”

A qualitative exploration of the barriers and facilitators affecting ethnic minority patient groups when accessing medicine review services: Perspectives of healthcare professionals

“…For instance, developing a greater awareness of potential cultural barriers that may arise with patients from ethnic minority groups should be a priority 48–53 . Thus, healthcare professionals may be better equipped with strategies to overcome them to facilitate better and equal access to appropriate medicine review and supportive care 48,54–57 …”

“…[48][49][50][51][52][53] Thus, healthcare professionals may be better equipped with strategies to overcome them to facilitate better and equal access to appropriate medicine review and supportive care. 48,[54][55][56][57] Communication is an important prerequisite for successful healthcare access and outcomes. 58 Due to the presence of a language barrier, studies have reported that ethnic minority patients with limited English demonstrate lower rates of medication adherence, make fewer visits to healthcare professionals, have reduced understanding of their conditions and treatment and develop increased medical complications.…”

“… 48 , 49 , 50 , 51 , 52 , 53 Thus, healthcare professionals may be better equipped with strategies to overcome them to facilitate better and equal access to appropriate medicine review and supportive care. 48 , 54 , 55 , 56 , 57 …”