https://orcid.org/0000-0002-1859-7699
Abstract
Purpose
The study assessed the association between medication beliefs and adherence in Middle Eastern refugees and migrants in Australia, and also examined differences between the two groups regarding beliefs and adherence to medication.
Patients and Methods
A total of 319 Middle Eastern refugees and migrants with hypertension were approached via various social groups in Australia and asked to complete Arabic versions of the Beliefs about Medicine Questionnaire (BMQ) and the Medication Adherence Questionnaire. BMQ scores (necessity and concerns scales) were classified as “accepting”, “indifferent”, “ambivalent” or “skeptical”. Multiple mediation modelling was applied to examine the role of necessity and concerns scales as mediators between migration status and medication adherence.
Results
There were significant associations between medication adherence and medication beliefs scores (necessity and concerns scales) (p=0.0001). Necessity and concern were mediators in the relationship between migration status and medication adherence. Significant differences were found between refugees and migrants for medication adherence and medication beliefs. Refugees were likely to have less necessity, and more concern beliefs than migrants, and were also less likely to adhere to medications. Almost 30% of refugees could be classified as skeptical and 40% as ambivalent. In contrast, 50% of migrants had accepting beliefs, and around 35% held ambivalent beliefs. Refugees and migrants with “accepting” beliefs reported the highest adherence to medication and those holding “skeptical” beliefs reported the lowest adherence.
Conclusion
Medication beliefs are potentially modifiable and are reasonable targets for clinical interventions designed to improve medication adherence. Understanding these beliefs and the likely differences between refugees and migrants is crucial to provide specific and targeted advice to each group independently in order to improve medication adherence and overall health.
Data Sharing Statement
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Ethics Approval and Consent to Participate
Ethics approval for this study was obtained from RMIT University Ethics Committee (SEHAPP 53-18). All participants provided informed consent, and this study was conducted in accordance with the Declaration of Helsinki.
Acknowledgments
The authors would like to thank Victorian Arabic Social Services, Kangan institute, Iraqi women’s social groups, and the administrators of the included Facebook groups, for assisting in recruitment of participants.
Author Contributions
WS collected the sample, organised the data, analysed and interpreted the data using SPSS, and wrote the first draft of the manuscript. GK reviewed drafts of the work, contributed to the conception and design of the work, and revised the analyses of the data and the work. WC analysed and interpreted the data, revised the work. IS reviewed drafts of the work, contributed to the conception and design of the work, and revised the work. All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest for this work.