Mindfulness is Associated with Medication Adherence in Older Adults
By John M. de Castro, Ph.D.
“Keep a watch…on the faults of the patients, which often make them lie about the taking of things prescribed. For through not taking disagreeable drinks, purgative or other, they sometimes die.” – Hippocrates, Decorum
“Integrating mindfulness into our practices may help foster the therapeutic alliance and ultimately medication adherence.” – Michael Ascher
In order for prescriptive medications to be effective in treating disease they must be taken. But about 50% of older patients do not take their medications as prescribed and many do not even fill their prescriptions. This is a shockingly high degree of non-compliance that can lead to poorer health and potentially death. Indeed, it has been stated that “increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments” (R. Brian Haynes). Mindfulness, on the other hand has been shown to be associated with better compliance with therapy and greater health related behaviors. So, it makes sense to study the role of mindfulness in medication adherence in older individuals.
In today’s Research News article “Selected psychological predictors of medication adherence in the older adults with chronic diseases.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729554/ ) Gruszczyńska and colleagues recruited older adults, over 60 year of age, who were diagnosed with a chronic disease. They completed measures of medication adherence, health locus of control, stress coping, and mindfulness.
They found that the higher the levels of medication adherence, the higher the levels of internal locus of control, influence of others locus of control, and mindfulness and the lower the levels of emotion-oriented coping and distraction seeking. Regression analysis revealed that the strongest positive predictors of medication adherence were influence of others locus of control, and mindfulness while the most powerful negative predictor was emotion-oriented coping.
It should be recognized that this study is correlational and as such causation cannot be determined. But these results make sense as ascribing the control of one’s health to other powerful people would suggest that the individual would be more likely to follow the direction of a physician and comply with the medicinal directions. That people who cope with stress emotionally would not adhere to medicinal directions also make sense as the invocation of strong emotions associated with the stress of the disease would be aversive and lead to avoidding or ignoring medicines associated with the source of stress.
Finally, mindfulness was found to be influential on medication adherence. Being more aware of and attentive to the needs of the body should lead to tending to those needs and taking prescribed medications to help. Indeed, mindfulness tends to promote health related behaviors in general. In other words, mindful people tend to do things that are beneficial for their health including taking prescribed medications as directed.
Since elderly people taking prescribed medications is one of the single most important contributors to their overall health and longevity, improving adherence is extremely important. Perhaps if training in mindfulness was prescribed along with medications, medication adherence may be improved leading to better health outcomes.
So, mindfulness is associated with medication adherence in older adults.
“Mindfulness interventions have been proven effective on several predictors of poor adherence (i.e., sleep, cognitive impairment, depression, and stress) and thus hold great potential to improve medication adherence.“ – Elena Salmoirago-Blotcher
CMCS – Center for Mindfulness and Contemplative Studies
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Gruszczyńska, M., Wyszomirska, J., Daniel-Sielańczyk, A., & Bąk-Sosnowska, M. (2020). Selected psychological predictors of medication adherence in the older adults with chronic diseases. Nursing open, 8(1), 317–326. https://doi.org/10.1002/nop2.632
The main goal of the study was to assess the significance of selected psychological factors related to the adherence to medication recommendations among the older adults with chronic diseases.
It was designed as a cross‐sectional study, aimed at assessing the importance of selected psychological factors in complying with medication recommendations among older adults.
The study involved 345 older adults with chronic diseases, assessed the importance of selected psychological factors, such as: health locus of control, stress coping and mindfulness in adhering to medication recommendations older persons. To answer the research questions, we performed frequency analyses, basic descriptive statistics analyses together with the Kolmogorov–Smirnov test, Student’s t tests for independent samples, monofactorial analysis of variance in the intergroup diagram, analysis correlation with the Pearson correlation coefficient, Spearman’s rank correlation ρ analysis and stepwise linear regression analysis.
The study identified psychological predictors of medication adherence, which explained 12% of the variability. An emotion‐oriented coping proved to be the most important factor. Additionally, powerful other health locus of control and mindful attention were shown to have a positive effect.