Impact Of Culture On Medication Adherence

Running head: IMPACT OF CULTURE ON MEDICATION ADHERENCE

Impact of Culture on Medication Adherence

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IMPACT OF CULTURE ON MEDICATION ADHERENCE 2

Impact of Culture on Medication Adherence

Introduction

Adherence to medication remains to be the fundamental determinant to the success of

treatment and patient outcomes. Failures to adhere to medication pose a serious challenge that

affects patients and the entire health care system (Jimmy & Jose, 2011). Non adherence to

treatment results in the worsening of disease condition, increased cost of healthcare and death of

patients (Jimmy & Jose, 2011). A number of factors account for the non-adherence to medication

in patients. These factors include the health care system, the provider of healthcare service, the

patient or the interaction of a number of factors. Therefore, it is necessary to identify specific

factors that hinder medication non adherence to improve the adherence levels and patient

outcomes. According to Jimmy and Jose (2011), while the healthcare professionals have a

fundamental role in the improvement of adherence to medication among patients, the cultures of

patients largely affect the treatment outcomes. This paper presents my position that culture has a

role to play in medication adherence, compliance drug choice and acceptance of an evidence-

based plan of medication management.

Medication adherence can be described as the level to which the medication-taking

behavior of patients matches up with the prescribed medication regimen. Appropriate adherence

to prescribed medications is crucial, especially among patients who have chronic conditions in

order to prevent the progression of the disease and ultimate death. On the other hand, culture is

defined as a set of behavioral patterns that are related to manners, thoughts, and actions, which

people in the society share and these behaviors are passed from one generation to another (Hatah,

Lim, Ali, et al., 2015). Culture plays an instrumental role in influencing the ability of a patient to

adhere to medication. Reports from the World Health organization indicate that less than half of

IMPACT OF CULTURE ON MEDICATION ADHERENCE 3

patients who suffer from chronic ailments adhere to their ailments (Hatah, Lim, Ali, et al., 2015).

These results were also observed in a study conducted in Malaysia which showed that among

hypertension patients, only 53.4% portrayed behaviors that indicated appropriate adherence to

medication.

Culture may influence the manner in which hypertension patients maintain their own

health and how they may adhere to the treatment regiments prescribed to them. While interacting

with patients, nurses and other providers should ensure that they provide cultural-based

education regarding the management of hypertension and other diseases. It has been noted that

African-Americans have unique illnesses and health beliefs, values and practices that predisposes

them to a number of diseases (Chia, Schlenk & Dunbar-Jacob, 2006). Among the affected group

are the low income populations or those that lack access to healthcare and those that have

stressful lives. This group of population also negates the required health behaviors that are

necessary to maintain their health.

Social support has the ability of positively influencing the health outcomes of patients

through various mechanisms such as adherence to medication. In Asian settings, studies have

revealed that cultural and religious orientations play an instrumental role when it comes to

medications adherence (Hatah, Lim, Ali, et al., 2015). When the culture of a patient is mixed

with low economic status and poverty, it tends to negatively affect the ability of the patient to

adhere to medication. Wasti, S., Randall, J., Simkhada (2011) say that adherence to medication is

a complex and challenging behavioral process. Therefore, it is particularly crucial for healthcare

providers to identify every modifiable risk factor that may lead to poor adherence.

In addition to culture, medication adherence may be influenced by numerous factors,

including patient’s demographics, disease conditions, and complexity of treatment. Moreover,

IMPACT OF CULTURE ON MEDICATION ADHERENCE 4

psychological factors like the susceptibility and severity of disease, difficulties and barriers it

using the medication, and the cost/benefit of the medication are some of the major factors that

influence the ability of the patient to adhere to medication (Chia, Schlenk & Dunbar-Jacob,

2006). However, numerous studies have indicated that the culture of the patient as well as the

way a person has been socialized plays a significant role influencing adherence to medication.

This is because such factors are closely related to health literacy, prescriber-patient relationship,

as well as the general health care system. In addition, social and economic factors of the patients,

including social support, the cost of medication, and religious beliefs play a significant role in

influencing m education adherence behavior of the patient.

Culture, which is made up of shared attributes such as heritage, religion, and language

tends to distinguish one group of people or society from another. People can understand culture

by analyzing values that are portrayed by individual’s behaviors on the basis of basic beliefs and

assumptions of its members. Hatah, Lim, Ali, et al. (2015) say that some instances of deep-

rooted Asian behaviors and values that differ from western behaviors include respecting elders,

harmonious relationships, group orientations of “we instead of I”, religious orientations, and the

concern for saving face. Since respecting other people and living in harmonious relationships

plays a significant role in the Asian culture, the way these values influence the decisions that are

made by patients who suffer from chronic conditions to take medication needs to be explored

further.

Culture and religiosity tend to play an instrumental role in influencing patients to adhere

to medication. Religiosity is defined as intrinsic religious beliefs as well as involvement in

religious activities (extrinsic). Culture and religion has the capability of empowering an

individual to connect with the community and have a superior force that influences

IMPACT OF CULTURE ON MEDICATION ADHERENCE 5

psychological stability (Wasti, Randall & Simkhada, 2011). Therefore, these factors have a huge

power in influencing an individual to adhere to medication. Over the past years, there have been

increased interests on the relationship between health, religion and culture.

Research studies carried out in the U.S. revealed that frequent participation in relations

activities tend to improve the health behavior of patients, including their social relationships, and

mental health. In a different study carried out in Uganda, adherence to medication is closely

related to religious and cultural practices. This study revealed that patients who had higher levels

of religiosity tended to adhere to various medications such as antiretroviral therapy. Due to

differences between religious and cultural orientations in Asian communities, the influence of

religion and cultural orientation on the perceived social support for patients has also been

witnessed.

According to Hatah, Lim, Ali, et al. (2015), cultures such as Malaysia tend to be

multicultural, and this implies that they have a distinct completion of Asian populations such as

Chinese, Malays, Indians, and so on. Therefore, it is worth investigating how cultural and

religious affiliations on its people influence medication adherence and social support of patients

to follow medical prescriptions. This is because in Malaysia, there are three major religions

which include Christianity, Islam, and Buddhism, and they have significant representation.

Studies have also revealed that there is a huge association between religion, races, and adherence

to medications (Wasti, Randall & Simkhada, 2011). Understanding the impact of culture as well

as religious orientations on medical adherence tend to assist in understanding the potential factor

that influence medication adherence.

In conclusion, this paper has showed that culture play an instrumental role in

medication adherence, compliance drug choice and acceptance of an evidence-based plan of

IMPACT OF CULTURE ON MEDICATION ADHERENCE 6

medication management. Studies have revealed that cultural orientations that are characterized in

patients tend to influence their perceived significance in medication adherence. Evidence has

also showed that when culture is mixed with religion, it tends to impact on the ability of a patient

to follow medical prescriptions. In addition, social support has a huge influence on medial

adherence. The religiosity of an individual, including the way a person has been socialized

influence the tendency to follow medical adherence. Moreover, patients who suffer from chronic

ailments may fail to adhere to medication due to numerous factors. Among these factors include

social support, the costs of medication, patient-provider relationships, and the general health care

systems. This paper has revealed that additional studies should be carried out to determine how

people living in multicultural societies are influenced to adhere to medications.

IMPACT OF CULTURE ON MEDICATION ADHERENCE 7

References:

Chia, L.R., Schlenk E. A., & Dunbar-Jacob, J. (2006). Effect of personal and cultural beliefs on

medication adherence in the elderly. Drugs Aging. 23(3):191-202

Hatah, E., Lim, K. P., Ali, A. M., Mohamed Shah, N., & Islahudin, F. (2015). The influence of

cultural and religious orientations on social support and its potential impact on

medication adherence. Patient Preference and Adherence, 9, 589–596.

Jimmy, B., & Jose, J. (2011). Patient medication adherence: Measures in daily practice. Oman

Medical Journal , 26(3):155-159

Wasti, S., Randall, J., Simkhada, P., & van Teijlingen, E. (2011). In what way do nepalese

cultural factors affect adherence to antiretroviral treatment in nepal? Health Science

Journal. 5(1). 37-47

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