Do psychological attributes matter for adherence to antihypertensive medication? The Finnish Public Sector Cohort Study
Open accessAbstract
OBJECTIVE: Psychological factors may be important determinants of adherence to antihypertensive medication, as they have been repeatedly found to be associated with an increased risk of hypertension, coronary heart disease, and health-damaging behaviours. We examined the importance of several psychological attributes (sense of coherence, optimism, pessimism, hostility, anxiety) with regard to antihypertensive medication adherence assessed by pharmacy refill records. METHODS: A total of 1021 hypertensive participants, aged 26-63 years, who were employees in eight towns and 12 hospitals in Finland were included in the analyses. RESULTS: We found 60% of patients to be totally adherent, 36% partially adherent, and 4% totally nonadherent. Multinomial regression analyses revealed high sense of coherence to be associated with lower odds of being totally nonadherent in contrast of being totally adherent (odds ratio=0.55; 95% confidence interval: 0.31-0.96). This association was independent of factors that influenced adherence to antihypertensive medication, such as sociodemographic characteristics, health-related behaviours, self-reported medical history of doctor-diagnosed comorbidity, and anteriority of hypertension status. The association was not specific to certain types of antihypertensive drugs. CONCLUSION: High sense of coherence may influence antihypertensive medication-adherence behaviour. Aspects characterizing this psychological attribute, such as knowledge (comprehensibility), capacity (manageability), and motivation (meaningfulness) may be important determinants of adherence behaviour for asymptomatic illnesses, such as hypertension, in which patients often do not feel or perceive the immediate consequences of skipping medication doses.
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The preponderance of current data supports a relationship between positive psychological factors and better medication and treatment adherence.
“Although fewer studies have considered whether positive psychological factors may lead to better medication and treatment adherence and findings are not fully consistent, the preponderance of current data support such a relationship. 156,157”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [157]
Cites
Osterberg, L., & Blaschke, T. (2005) · New England Journal of Medicine · doi:10.1056/nejmra050100 · Cited by 7,974 · see citing works
Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.67.6.1063 · Cited by 7,456 · see citing works
Adherence to Long-Term Therapies: Evidence for Action
Geest, S. D., & Sabate, E. J. (2003) · European Journal of Cardiovascular Nursing · doi:10.1016/s1474-5151(03)00091-4 · Cited by 6,274 · see citing works
Unraveling the Mystery of Health: How People Manage Stress and Stay Well
Antonovsky, A. (2002) · SAGE Publications Ltd eBooks · doi:10.4135/9781446221129.n9 · Cited by 5,525 · see citing works
Kirk, J. M. W., MacDonald, A., Lavender, P., Dean, J. M., & Rubin, G. (2017) · Biomedicine Hub · doi:10.1159/000480347 · Cited by 3,901 · see citing works
The Validity of Two Versions of the GHQ in the WHO Study of Mental Illness in General Health Care
GOLDBERG, D. P., GATER, R., SARTORIUS, N., USTUN, T. B., PICCINELLI, M., GUREJE, O., & RUTTER, C. (1997) · Psychological Medicine · doi:10.1017/s0033291796004242 · Cited by 3,657 · see citing works
The structure and properties of the sense of coherence scale
Antonovsky, A. (1993) · Social Science & Medicine · doi:10.1016/0277-9536(93)90033-z · Cited by 3,515 · see citing works
Rozanski, A., Blumenthal, J. A., & Kaplan, J. (1999) · Circulation · doi:10.1161/01.cir.99.16.2192 · Cited by 2,846 · see citing works
World Health Organization, I. S. O. H. W. G. (2003) · Journal of Hypertension · doi:10.1097/00004872-200311000-00002 · Cited by 2,654 · see citing works
Adherence to Long‐Term Therapies: Evidence for Action
Burkhart, P. V., & Sabaté, E. (2003) · Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.2003.tb00001.x · Cited by 2,526 · see citing works
Manual for the state-trait anxiety inventory (form Y) : "self-evaluation questionnaire"
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970) · Consulting Psychologists Press eBooks · Cited by 2,352 · see citing works
Relationship of Leisure-Time Physical Activity and Mortality
Kujala, U. M., Kaprio, J. A., Sarna, S. J., & Koskenvuo, M. J. (1998) · JAMA · doi:10.1001/jama.279.6.440 · Cited by 603 · see citing works
Haapanen, N., Miilunpalo, S. I., Pasanen, M. E., Oja, P., & VUORI, I. M. (1997) · American Journal of Epidemiology · doi:10.1093/aje/145.8.762 · Cited by 415 · see citing works
Schnall, P. L. (1990) · JAMA · doi:10.1001/jama.263.14.1929 · Cited by 408 · see citing works
Noncompliance with antihypertensive medications
Wang, P. S., Bohn, R. L., Knight, E. L., Glynn, R. J., Mogun, H., & Avorn, J. (2002) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2002.00406.x · Cited by 373 · see citing works
Validation of pharmacy records in drug exposure assessment
Lau, H. S., de Boer, A., Beuning, K. S., & Porsius, A. J. (1997) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(97)00040-1 · Cited by 371 · see citing works
Medication Adherence and Persistence as the Cornerstone of Effective Antihypertensive Therapy
Burnier, M. (2006) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2006.04.006 · Cited by 356 · see citing works
Organisational downsizing, sickness absence, and mortality: 10-town prospective cohort study
Vahtera, J., Mika Kivimaki, B., Pentti, J., Linna, A., Virtanen, M., Virtanen, P., & Ferrie, J. E. (2004) · BMJ · doi:10.1136/bmj.37972.496262.0d · Cited by 343 · see citing works
Self-citationSchnall, P. L. (1990) · JAMA · doi:10.1001/jama.1990.03440140055031 · Cited by 277 · see citing works
Sense of coherence and health: evidence from two cross-lagged longitudinal samples
Kivimäki, M., Feldt, T., Vahtera, J., & Nurmi, J.-E. (2000) · Social Science & Medicine · doi:10.1016/s0277-9536(99)00326-3 · Cited by 262 · see citing works
Self-citationHostility as a risk factor for mortality and ischemic heart disease in men.
Koskenvuo, M., Kaprio, J., Rose, R. J., Kesäniemi, A., Sarna, S., Heikkilä, K., & Langinvainio, H. (1988) · Psychosomatic Medicine · doi:10.1097/00006842-198807000-00002 · Cited by 232 · see citing works
Antihypertensive Medication Adherence in the Department of Veterans Affairs
Siegel, D., Lopez, J., & Meier, J. L. (2007) · The American Journal of Medicine · doi:10.1016/j.amjmed.2006.06.028 · Cited by 227 · see citing works
Mika Kivimaki, B., Lawlor, D. A., Smith, G. D., Kouvonen, A. M., Virtanen, M., Elovainio, M. J., & Vahtera, J. (2007) · American Journal of Public Health · doi:10.2105/ajph.2005.078691 · Cited by 193 · see citing works
Self-citationLong-term Results, Late Complications and Quality of Life in a Series of Adjustable Gastric Banding
Martikainen, T., Pirinen, E., Alhava, E. M., Poikolainen, E., Pääkkönen, M. E., Uusitupa, M. I. J., & Gylling, H. K. (2004) · Obesity Surgery · doi:10.1381/096089204323093435 · Cited by 136 · see citing works
Barriers to hypertension control
Borzecki, A. M., Oliveria, S. A., & Berlowitz, D. R. (2005) · American Heart Journal · doi:10.1016/j.ahj.2005.01.047 · Cited by 127 · see citing works
Compliance With Prescription Filling in the Pediatric Emergency Department
Matsui, D. M., Joubert, G., Dykxhoorn, S., & Rieder, M. J. (2000) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.154.2.195 · Cited by 79 · see citing works
Relation Between Sense of Coherence and Glycemic Control in Type 1 and Type 2 Diabetes
Cohen, M. W., & KANTER, Y. (2004) · Behavioral Medicine · doi:10.3200/bmed.29.4.175-185 · Cited by 67 · see citing works
Hill, M. (1999) · American Journal of Hypertension · doi:10.1016/s0895-7061(99)00007-2 · Cited by 67 · see citing works
Identification of psychosocial factors of noncompliance in hypertensive patients
Hassan, N. B., Hasanah, C. I., Foong, K., Naing, L., Awang, R., Ismail, S. B., Ishak, A., Yaacob, L. H., Yusoff, H. M., Daud, A., et al. (2005) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1001930 · Cited by 65 · see citing works
Low organisational justice and heavy drinking: a prospective cohort study
Kouvonen, A. M., Mika Kivimaki, B., Elovainio, M. J., Väänänen, A., Vogli, R. D., Heponiemi, T., Linna, A., Pentti, J., & Vahtera, J. (2007) · Occupational and Environmental Medicine · doi:10.1136/oem.2007.032755 · Cited by 65 · see citing works
Self-citationSpiro, A., Aldwin, C. M., Ward, K. D., & Mroczek, D. K. (1995) · Health Psychology · doi:10.1037/0278-6133.14.6.563 · Cited by 55 · see citing works
Persistent high job demands and reactivity to mental stress predict future ambulatory blood pressure
Steptoe, A., & Cropley, M. (2000) · Journal of Hypertension · doi:10.1097/00004872-200018050-00011 · Cited by 54 · see citing works
Cederfjäll, C., Langius‐Eklöf, A., Lidman, K., & Wredling, R. (2002) · AIDS Patient Care and STDs · doi:10.1089/108729102761882143 · Cited by 47 · see citing works
Adherence Assessment to Highly Active Antiretroviral Therapy
Tsasis, P. (2001) · AIDS Patient Care and STDs · doi:10.1089/108729101750123544 · Cited by 43 · see citing works
Lee, D. J., de Leon, C. F. M., Jenkins, C. D., Croog, S. H., Levine, S., & Sudilovsky, A. (1992) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(92)90027-y · Cited by 36 · see citing works
Adherence to HIV Regimens: 10 Vital Lessons
Williams, A. B. (2001) · AJN American Journal of Nursing · doi:10.1097/00000446-200106000-00019 · Cited by 14 · see citing works
Flagged first, then by citations
2 of the 38 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Levine, G. N., Cohen, B. E., Commodore-Mensah, Y., Fleury, J., Huffman, J. C., Khalid, U., Labarthe, D. R., Lavretsky, H., Michos, E. D., Spatz, E. S., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000947 · Cited by 865 · see citing works
Factors associated with antihypertensive medication non-adherence: a systematic review
van der Laan, D. M., Elders, P. J. M., Boons, C. C. L. M., Beckeringh, J. J., Nijpels, G., & Hugtenburg, J. G. (2017) · Journal of Human Hypertension · doi:10.1038/jhh.2017.48 · Cited by 155 · see citing works
Positive psychological attributes and cardiac outcomes: associations, mechanisms, and interventions
DuBois, C. M., Beach, S. R., Kashdan, T. B., Nyer, M. B., Park, E. R., Celano, C. M., & Huffman, J. C. (2012) · Psychosomatics · doi:10.1016/j.psym.2012.04.004 · Cited by 152 · see citing works
Medication nonfulfillment rates and reasons: narrative systematic review
Gadkari, A. S., & McHorney, C. A. (2010) · Current Medical Research and Opinion · doi:10.1185/03007990903550586 · Cited by 103 · see citing works
Barriers to Adult Hemodialysis Patients' Self-Management of Oral Medications
Browne, T. A., & Merighi, J. R. (2010) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2010.03.002 · Cited by 93 · see citing works
Optimism’s Explicative Role for Chronic Diseases
Avvenuti, G., Baiardini, I., & Giardini, A. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.00295 · Cited by 71 · see citing works
Sylvia, L. G., Hay, A., Ostacher, M. J., Miklowitz, D. J., Nierenberg, A. A., Thase, M. E., Sachs, G. S., Deckersbach, T., & Perlis, R. H. (2013) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3182900c6f · Cited by 62 · see citing works
Workplace social capital and risk of chronic and severe hypertension
Oksanen, T., Kawachi, I. I., Jokela, M. M., Kouvonen, A. M., Suzuki, E., Takao, S., Virtanen, M., Pentti, J., Vahtera, J., & Mika Kivimaki, B. (2012) · Journal of Hypertension · doi:10.1097/hjh.0b013e32835377ed · Cited by 48 · see citing works
Self-citationMartin, G., Patel, N. C., Grant, Y., Jenkins, M. P., Gibbs, R. G. J., & Bicknell, C. D. (2018) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2017.12.063 · Cited by 39 · see citing works
Crowley, M. J., Grubber, J. M., Olsen, M. K., & Bosworth, H. B. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2195-1 · Cited by 38 · see citing works
Saastamoinen, L., & Verho, J. (2015) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3764 · Cited by 34 · see citing works
Zwikker, H. E., van den Bemt, B. J. F., Vriezekolk, J. E., van den Ende, C. H. M., & van Dulmen, S. (2014) · Patient Preference and Adherence · doi:10.2147/ppa.s47290 · Cited by 34 · see citing works
Šilarova, B., Nagyová, I., Rosenberger, J., Studenčan, M., Ondušová, D., Reijneveld, S. A., & van Dijk, J. P. (2013) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515113497136 · Cited by 33 · see citing works
Roohafza, H., Kabir, A., Sadeghi, M., Shokouh, P., Ahmadzad-Asl, M., Maboudi, A. A. K., & Sarrafzadegan, N. (2016) · Europe PMC (PubMed Central) · Cited by 31 · see citing works
Adherence to anti‐hypertensive medication: Proposing and testing a conceptual model
Quine, L., Steadman, L., Thompson, S., & Rutter, D. R. (2011) · British Journal of Health Psychology · doi:10.1111/j.2044-8287.2011.02034.x · Cited by 30 · see citing works
Carvalho, A. S., & Santos, P. (2019) · Patient Preference and Adherence · doi:10.2147/ppa.s216091 · Cited by 25 · see citing works
Workplace Social Capital and Adherence to Antihypertensive Medication: A Cohort Study
Oksanen, T., Kawachi, I. I., Kouvonen, A. M., Suzuki, E., Takao, S., Sjösten, N., Virtanen, M., Pentti, J., Vahtera, J., & Mika Kivimaki, B. (2011) · PLoS ONE · doi:10.1371/journal.pone.0024732 · Cited by 18 · see citing works
Self-citationPänkäläinen, M., Fogelholm, M., Valve, R., Kampman, O., Kauppi, M. J., Lappalainen, E., & Hintikka, J. (2018) · Nutrition Journal · doi:10.1186/s12937-018-0400-8 · Cited by 18 · see citing works
Orr, P. (2011) · International Journal of Circumpolar Health · doi:10.3402/ijch.v70i2.17809 · Cited by 17 · see citing works
Hedegaard, U., Hallas, J., Ravn‐Nielsen, L. V., & Kjeldsen, L. J. (2015) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2015.05.006 · Cited by 16 · see citing works
Sense of coherence and chronic illnesses: Scope for research in India
Chittem, M., Lindström, B., Byrapaneni, R., & Espnes, G. A. (2015) · Journal of Social Health and Diabetes · doi:10.4103/2321-0656.152803 · Cited by 14 · see citing works
SALUTOGENESIS AND CARDIOVASCULAR HEALTH IN ADULTS: A SCOPING REVIEW
Garzón, N. E., & Heredia, L. P. D. (2020) · Texto & Contexto - Enfermagem · doi:10.1590/1980-265x-tce-2018-0376 · Cited by 10 · see citing works
The Application of Salutogenesis to Health Development in Youth with Chronic Conditions
Aujoulat, I., Mustin, L., Martin, F., Pélicand, J., & Robinson, J. (2016) · Springer eBooks · doi:10.1007/978-3-319-04600-6_32 · Cited by 9 · see citing works
Tas legemidler som foreskrevet?
Hov, I., Bjartnes, M., Slørdal, L., & Spigset, O. (2012) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.11.0225 · Cited by 8 · see citing works
Olesen, K., Jensen, T. M., Díaz, L. J., Møller, A. C. L., Willaing, I., & Lyssenko, V. (2017) · Journal of Clinical & Translational Endocrinology · doi:10.1016/j.jcte.2017.01.003 · Cited by 8 · see citing works
Medication adherence: a review of pharmacy education, research, practice and policy in Finland
Bell, J. S., Enlund, H., & Vainio, K. (2010) · Pharmacy Practice · doi:10.4321/s1886-36552010000300001 · Cited by 7 · see citing works
Perceived HIV symptom manageability: synthesis of a new use for a known concept
Fierz, K., Nicca, D., & Spirig, R. (2012) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2012.06068.x · Cited by 7 · see citing works
Hospital Pharmacy Pulse - Recent Publications on Medications and Pharmacy
Sterling, J. A. (2007) · Hospital Pharmacy · doi:10.1310/hpj4206-578 · Cited by 7 · see citing works
Factors Related to Medication Adherence in Adult Patients with Tuberculosis
Jung, E. Y., & Hwang, S.-K. (2018) · Korean Journal of Adult Nursing · doi:10.7475/kjan.2018.30.5.493 · Cited by 6 · see citing works
Reimagining Medication Adherence: A Novel Holistic Model for Hypertension Therapy
Schäfer, C. (2024) · Patient Preference and Adherence · doi:10.2147/ppa.s442645 · Cited by 6 · see citing works
Psychosocial Factors in Coronary Heart Disease
Gidron, Y. (2019) · Springer eBooks · doi:10.1007/978-3-030-18893-1_4 · Cited by 3 · see citing works
Psychological Care of Cardiac Patients
Bennett, P. D. (2010) · Springer eBooks · doi:10.1007/978-1-84882-794-3_3 · Cited by 2 · see citing works
Health service factors that affect adherence to tuberculosis treatment in Ghana
Salifu, Y., Eliason, C., & Mensah, G. B. (2018) · Primary Health Care · doi:10.7748/phc.2018.e1312 · Cited by 2 · see citing works
Realdi, A., Favaro, A., Santonastaso, P., Nuti, M., Parotto, E., Inverso, G., Leoni, M., Macchini, L., Vettore, F., Calò, L. A., et al. (2009) · Pharmaceuticals · doi:10.3390/ph2030082 · Cited by 1 · see citing works
Response to Knowing Hypertension Awareness and Psychological Distress in Primary Prevention
Hamer, M., Batty, G. D., Stamatakis, E. A., & Mika Kivimaki, B. (2010) · Hypertension · doi:10.1161/hypertensionaha.110.161968 · Cited by 1 · see citing works
Marie-Chantale, N. (2020) · Open Access Journal of Cardiology · doi:10.23880/oajc-16000153 · Cited by 1 · see citing works
Das Krankenhaus – ein kohärentes Setting?
Kada, O., Brunner, E., & Maier, M. J. (2011) · Prävention und Gesundheitsförderung · doi:10.1007/s11553-011-0304-3 · Cited by 1 · see citing works
Intervention und Follow-Up nach hypertensiver Entgleisung
Renneberg, S. D. (2022) · doi:10.53846/goediss-9464
Recent Publications on Medications and Pharmacy
Sterling, J. A. (2008) · Hospital Pharmacy · doi:10.1310/hpj4312-1024
Matsushita, S., Yamazaki, H., Yamada, Y., Ogawa, Y., & Yamamoto, Y. (2026) · PLoS ONE · doi:10.1371/journal.pone.0355726
- Authors
- Nabi, H., Vahtera, J., Singh-Manoux, A., Pentti, J., Oksanen, T., Gimeno, D., Elovainio, M., Virtanen, M., Klaukka, T., & Kivimaki, M.
- Affiliations
- University College London (GB)
- Finnish Institute of Occupational Health (FI)
- Finnish Institute for Health and Welfare (FI)
- Social Insurance Institution (FI)
- Corresponding author
- Nabi, Hermann
- Venue
- Journal of Hypertension
- Published
- 2008-11
- Volume
- 26
- Issue
- 11
- Pages
- 2236-2243
- ISSN
- 0263-6352 (ISSN-L)
- PMC
- PMC2784079
- OpenAlex
- W1981274671
- Cited by
- 43
- References
- 38
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 1 · 2013: 2 · 2012: 5
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- antihypertensive medication adherence, sense of coherence, optimism, pessimism, hostility, anxiety, psychological factors, hypertension, public sector employees
- MeSH terms
- Adult, Antihypertensive Agents, Female, Finland, Humans, Hypertension, Male, Middle Aged, Patient Compliance, Prospective Studies, Regression Analysis, Comorbidity, Odds Ratio, Treatment Refusal
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