Does Happiness Predict Medication Adherence among African Americans with Hypertension?
- 313 Downloads
Poor medication adherence is a leading cause of excessive cardiovascular morbidity among African Americans. Many adherence-promoting interventions have addressed economic barriers, improved the patient-provider relationship, simplified regimens, and used reminder systems; however, the problem of low adherence remains intractable. Meanwhile, positive psychological attributes that might serve to promote medication adherence have not been fully explored. To address this gap, we examined the association between happiness and medication adherence among low-income African Americans with hypertension treated in a safety-net setting. Data were obtained from the Alabama Collaboration for Cardiovascular Equality, 2007–2008. Happiness was measured using the 4-item scale of Lyubomirsky and Lepper; low, moderate, and high happiness were defined by tertiles because of the non-normal distribution. Medication adherence was assessed with the Morisky Medication Adherence Scale. Associations were quantified with ordinal logistic regression. Our sample of 573 African Americans was 71.6 % female and had an average age ± SD of 53.6 ± 9.7 years and a median happiness score of 5.2. Compared to participants with low happiness, the odds (OR; 95 % CI) of being in a better medication adherence category were greater for those with moderate (1.53; 1.02–2.27) and high (2.26; 1.52-3.37) happiness, after adjusting for age, sex, income, education, and difficulty paying for medical care. Within this cohort of low-income African Americans with hypertension, participants with greater happiness exhibited better medication adherence. Although one interpretation of our study is that more adherent patients are naturally happier, our findings raise the possibility that adding happiness-boosting components may increase the effectiveness of more traditional adherence interventions.
KeywordsHappiness Medication adherence Hypertension African Americans
The TRUST study was funded by the National Lung, Heart, and Blood Institute. Grant number: U01 HL079171-01. Yendelela Cuffee is funded by a dissertation grant from the Agency of Healthcare Research and Quality. Grant number: 1R36HS020755-01
- Burrell, C. (1984). Theraputic consequences of noncompliances. In: Improving medication complaince. Proceedings of a symposium. National Pharmaceutical Council, Washington, DC.Google Scholar
- Diener, E. (2008). Happiness unlocking the mysteries of psychological wealth. Blackwell Publishing.Google Scholar
- Haynes, R. B., Ackloo, E. et al. (2008). Interventions for enhancing medication adherence. Cochrane database of systematic reviews (2): CD000011.Google Scholar
- Lyubomirsky (1999). A Measure of Subjective Happiness: Preliminary Reliability and Construct Validation. Social Indicators Research (Feb 1999): 137.Google Scholar
- Martin, L. R., Williams, S. L., et al. (2005). The challenge of patient adherence. Therapeutics and Clinical Risk Management, 1(3), 189–199.Google Scholar
- National Institutes of Health; National Heart, L., and Blood Institute (1997). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure—Complete Report. Hypertension. N. H. B. P. E. Program. Bethesda, MD, pp. 98–4080Google Scholar
- Ogedegbe, G., Harrison, M., et al. (2004). Barriers and facilitators of medication adherence in hypertensive African Americans: a qualitative study. Ethnicity & Disease, 14(1), 3–12.Google Scholar
- Otsuki, M., Clerisme-Beaty, E., et al. (2009). Measuring adherence to medication regimens. In S. A. Shumaker, J. K. Ockene, & K. A. Riekert (Eds.), Clinical care and research. The handbook of health behavior change (3rd ed.). New York: Springer.Google Scholar
- Rogers, W. H. (1992). Quantile regression standard errors. Stata Technical Bulletin, 9, 16–19.Google Scholar