The Influence of Spirituality on Medication Adherence And Blood Pressure Among Older Adults With Hypertension

Yon, Amica Simmons

The Influence of Spirituality on Medication Adherence And Blood Pressure Among Older Adults With Hypertension Public Deposited

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March 22, 2019

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Yon, Amica Simmons
- Affiliation: Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy

Abstract

Despite the effectiveness of pharmacological therapies, medication nonadherence is prevalent among older adults with chronic disease. Established correlates of adherence (e.g., access, race/ethnicity, education) do not fully explain the differences in adherence. This study examines whether spirituality contributes to older adults' medication adherence and blood pressure, as well as the indirect pathways by which spirituality may be linked to self-reported adherence behavior, with social support and active coping as putative mediators. A cross-sectional analysis was performed on data from surveys on spirituality, social support, active coping, and adherence behavior administered to a convenience sample of Black and White hypertensive, older adults (≥ 65 years) visiting senior community centers in North Carolina, along with demographic characteristics and blood pressure measurements. Multivariate logistic and linear regressions were used to examine the relationship between spirituality and self-reported medication adherence and blood pressure, respectively, after adjusting for the psychosocial and demographic characteristics. Results revealed that perceived spiritual intensity and active spiritual health locus of control (SHLC) were significantly and positively associated with medication adherence. The psychosocial variables were significantly related to both perceived spirituality and medication adherence but were not significant mediators. High spirituality and active SHLC beliefs were also significantly related to lower systolic and diastolic blood pressures after controlling for adherence and the psychosocial and demographic variables. These findings highlight the importance of spirituality in adherence behavior and health outcomes for some older adults with chronic disease. Better understanding of the mechanisms and role of spirituality in medication-taking behavior and health outcomes will aid researchers and health professionals in the development of culturally sensitive and patient-centered interventions to improve medication adherence and cardiovascular outcomes.

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