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Applied Research in Quality of Life

, Volume 7, Issue 4, pp 403–412 | Cite as

Does Happiness Predict Medication Adherence among African Americans with Hypertension?

  • Yendelela L. Cuffee
  • Erik Angner
  • Norman Oliver
  • Deborah Plummer
  • Catarina Kiefe
  • Sandral Hullett
  • Jeroan Allison
Article
  • 313 Downloads

Abstract

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.

Keywords

Happiness Medication adherence Hypertension African Americans 

Notes

Acknowledgments

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

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Copyright information

© Springer Science+Business Media B.V./The International Society for Quality-of-Life Studies (ISQOLS) 2012

Authors and Affiliations

  • Yendelela L. Cuffee
    • 1
  • Erik Angner
    • 2
  • Norman Oliver
    • 3
  • Deborah Plummer
    • 4
  • Catarina Kiefe
    • 1
  • Sandral Hullett
    • 5
  • Jeroan Allison
    • 1
  1. 1.Department of Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Department of PhilosophyGeorge Mason UniversityFairfaxUSA
  3. 3.Department of Family MedicineUniversity of Virginia School of MedicineCharlottesvilleUSA
  4. 4.Department of PsychiatryUniversity of Massachusetts Medical SchoolWorcesterUSA
  5. 5.Cooper Green Mercy HospitalBirminghamUSA

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