Date of Award
1-1-2023
Document Type
Thesis
Degree Name
M.S. in Pharmaceutical Science
First Advisor
Erin R. Holmes
Second Advisor
Yi Yang
Third Advisor
John P. Bentley
Relational Format
dissertation/thesis
Abstract
Background: Primary nonadherence (PMN) to antihypertensives constitutes a problem for all stakeholders regardless of whose perspective is taken. Understanding patient beliefs and utilizing a theory could help move the needle in favor of antihypertensive medications initiation.
Objectives: To determine the predictive ability of an integrated model of the theory of planned behavior and health belief model on intention to initiate an antihypertensive medication and to rank the identified factors of intentions to initiate antihypertensive medications in order of relative importance.
Methods: A cross-sectional survey was conducted to evaluate beliefs and factors that determine intention to initiate antihypertensive medications. The sample was sourced from a national online panel provided by Qualtrics. Bivariate analysis was conducted to determine the relationships among the constructs, as well as between each construct and intentions. Multivariable analysis was also carried out, controlling for potential confounders. To ascertain which construct was most important in predicting intention, relative weight analysis was used.
Results: A total of 941 participants took part in the study with an average age of 41.3 years and a standard deviation of 14.8 years. Model 1 comprising of twelve predictors accounted for 8% (R2 = 0.08) of the variation in intention. Model 2 incorporated an additional seven variables for a total of nineteen predictors. This model explained an additional 65% (R2 = 0.65) of the variation in intention resulting in a total variance explained of 73% (R2 = 0.73). Overall, Attitude, Subjective norm, Perceived behavioral control, and Perceived severity had a positive significant relationship with the intention to initiate antihypertensive medications while Perceived barrier had a negative significant relationship. However, the relationship for perceived benefits as well as perceived susceptibility was not statistically significant. The results of the relative weight analysis indicates that the most important variables in predicting intention to initiate antihypertensive medications are Subjective Norm (RW = 0.22 or 30.84% of the explained variance), Perceived Behavioral Control (RW = 0.19 or 26.04% of the explained variance), and Attitude (RW = 0.13 or 17.17% of the explained variance).
Conclusion: One of the recommendations by the World Health Organization (WHO) for addressing medication nonadherence is a tailored intervention approach. Amid scarce resources, targeting interventions towards factors deemed most important could result in tremendous cost savings for all stakeholders. This cost saving would be achieved through decreased healthcare costs from preventable hospitalizations and waste, increased patient quality of life, increased productivity and a resultant improvement in health economics and outcomes.
Recommended Citation
Eriakha, Omokhodion Alfred, "Beliefs and Factors That Influence Intentions to Initiate Antihypertensive Medications" (2023). Electronic Theses and Dissertations. 2750.
https://egrove.olemiss.edu/etd/2750