A Prospective Cohort Study of Medication Beliefs and their Impact on Medication Adherence in Aboriginal and Nonaboriginal Patient

ABSTRACT

@#Introduction: Most research has primarily focused on the influence of patients' beliefs on medication adherence in non-aboriginal populations. This study compared medication beliefs among aboriginal and non-aboriginal patients with hypertension and/or diabetes mellitus, predictors of medication beliefs, and their impact on medication adherence. Methods: A prospective cohort study was conducted using the Beliefs about Medicines Questionnaire-Specific on a randomly selected sample of 38 patients for each group. Medication adherence was measured by pill counts and prescription refill history. Results: Over half of the aboriginal and non-aboriginal patients believed that the medications are necessary for their health. In particular, aboriginal patients had higher necessity score (mean 21.32, SD 2.90) than non-aboriginal patients (mean 19.45, SD 3.68, p<0.05). More aboriginal patients worried about the longterm effects of their medications (78.9%) and drug dependence (81.6%). In aboriginal group, greater disease knowledge was associated with higher necessity scores [F(1,36)=12.67, p<0.05, R2=0.26] and positive necessity-concerns differential (NCD) [F(1,36)=6.092, p<0.05, R2=0.145]. In non-aboriginal group, older patients were associated with higher necessity scores [F(1,36)=5.855, p<0.05, R2=0.140] while females were associated with greater concerns scores [F(1,36)=6.170, p<0.05, R2=0.146] and negative NCD, which had also been observed in the employed patients [F(2,35)=7.314, p<0.05, R2=0.295]. Medication non-adherence was more prevalent among aboriginal patients (73.7%) and was predominantly associated with higher concerns in both groups. Conclusion: Despite strong medication necessity beliefs, levels of concerns were substantial in both groups and were associated with medication non-adherence. More patient-centred approaches should be designed to address patients' concerns and improve treatment outcomes.