Other Titles

Rising Star Poster/Presentation - Rapid Presentation Round

Abstract

Several effective treatment options are currently available for patients with pulmonary hypertension (PH), including pharmacologic therapies such as breakthrough prostacyclin infusions, the use of durable medical equipment’s, and a myriad of lifestyle modifications. In spite of the availability of these treatment options, many patients remain unsure about their disease and the regular use of recommended treatment. Treatment adherence is defined as the extent to which a person's medication taking behavior, diet, and lifestyle changes corresponds with agreed health care providers recommendations (Burkhart & Sabaté, 2003). Even though a plethora of research has addressed treatment adherence among patients with various diagnoses, little is known about this phenomenon among patients with PH. This presentation proposes an integrative conceptual framework to understand treatment adherence among patients diagnosed with PH based on the Health belief Model and the Theory of Planned Behavior. The presentation also provides a critical review of the literature around this phenomenon by addressing five major dimensions. The first dimension includes the effect of social demographic and illness characteristic on treatment adherence. For example, studies reported lower treatment adherence levels among patients with PH who are younger, of lower socioeconomic status, with mild to moderate disease severity, and have comorbid health conditions. The second dimension is patient's beliefs that affect health behaviors, including patient perceptions around illness severity, treatment effectiveness, barriers to treatment, and motivation/ cues to action. The third dimension includes the impact of self-efficacy on treatment adherence, which has not been examined specifically among patients with PH but has been documented in the literature to positively impact health behaviors. The fourth focuses on subjective norms, which includes social support and provider communications. Studies have shown that treatment adherence is higher among patients with higher level of social support in the form of a spouse, caregivers, support groups, etc. In addition, healthcare providers play a critical role in promoting treatment adherence through the quality of their communication and the provision of clear and strong treatment recommendations. The fifth dimension focuses on access to care factors that impact treatment adherence among patients with PH. These include having insurance, having primary care provider, and having access to PH specialty healthcare services. Based on the proposed integrative conceptual framework and the review of the existing studies, implications for future research include the need for studies to examine the effect of socio-demographic and illness characteristics, patient believes, self-efficacy, subjective norms, and access to care among patients with PH on the treatment adherence. Such research is needed to guide the development of intervention strategies to improve patient adherence and to informed clinicians on ways to address their patient needs.

Notes

References:

Kjellström, B., Sandqvist, A., Hjalmarsson, C., Nisell, M., Näsman, P., & Ivarsson, B. (2020). Adherence to disease-specific drug treatment among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. ERJ Open Res, 6(4). https://doi.org/10.1183/23120541.00299-2020

Ivarsson, B., Hesselstrand, R., Rådegran, G., & Kjellström, B. (2018). Adherence and medication belief in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension: A nationwide population-based cohort survey. Clin Respir J, 12(6), 2029-2035. https://doi.org/10.1111/crj.12770

Aggarwal, S., Paul, G., Paul, B. S., Mahendru, D., & Goyal, S. (2021). Factors Affecting Adherence to Pharmacotherapy in Parkinson's Disease. Ann Indian Acad Neurol, 24(6), 879-884. https://doi.org/10.4103/aian.AIAN_143_21

Ahmed, R. E., Bdair, I. A., Al-Mugheed, K., Alshahrani, S. H., Alalyani, M. M., Ramaiah, R., Abdelrahman, S. I., Mahmoud, S. A., & Arrab, M. M. (2023). Empowering Self-Efficacy by Using Patient Empowerment among Chronic Obstructive Pulmonary Disease: Pre-Post-Test Study. Healthcare (Basel), 11(3). https://doi.org/10.3390/healthcare11030430

Description

Several effective treatment options are currently available for patients with pulmonary hypertension (PH).In spite of the available treatment options, many patients remain unsure about their disease and recommended treatment. Little is known about treatment adherence among patients with PH. This presentation proposes an integrative conceptual framework to understand treatment adherence.

Author Details

Justin Wilson, MSN, APRN, PhD-Candidate; Jill Cox, PhD, APRN, FAAN; Rula Btoush, PhD, RN

Sigma Membership

Theta Tau

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Pulmonary Hypertension, Treatment Adherence, Pulmonary Hypertension Treatment

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-02-16

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Understanding Treatment Adherence among Patients with Pulmonary Hypertension

Washington, DC, USA

Several effective treatment options are currently available for patients with pulmonary hypertension (PH), including pharmacologic therapies such as breakthrough prostacyclin infusions, the use of durable medical equipment’s, and a myriad of lifestyle modifications. In spite of the availability of these treatment options, many patients remain unsure about their disease and the regular use of recommended treatment. Treatment adherence is defined as the extent to which a person's medication taking behavior, diet, and lifestyle changes corresponds with agreed health care providers recommendations (Burkhart & Sabaté, 2003). Even though a plethora of research has addressed treatment adherence among patients with various diagnoses, little is known about this phenomenon among patients with PH. This presentation proposes an integrative conceptual framework to understand treatment adherence among patients diagnosed with PH based on the Health belief Model and the Theory of Planned Behavior. The presentation also provides a critical review of the literature around this phenomenon by addressing five major dimensions. The first dimension includes the effect of social demographic and illness characteristic on treatment adherence. For example, studies reported lower treatment adherence levels among patients with PH who are younger, of lower socioeconomic status, with mild to moderate disease severity, and have comorbid health conditions. The second dimension is patient's beliefs that affect health behaviors, including patient perceptions around illness severity, treatment effectiveness, barriers to treatment, and motivation/ cues to action. The third dimension includes the impact of self-efficacy on treatment adherence, which has not been examined specifically among patients with PH but has been documented in the literature to positively impact health behaviors. The fourth focuses on subjective norms, which includes social support and provider communications. Studies have shown that treatment adherence is higher among patients with higher level of social support in the form of a spouse, caregivers, support groups, etc. In addition, healthcare providers play a critical role in promoting treatment adherence through the quality of their communication and the provision of clear and strong treatment recommendations. The fifth dimension focuses on access to care factors that impact treatment adherence among patients with PH. These include having insurance, having primary care provider, and having access to PH specialty healthcare services. Based on the proposed integrative conceptual framework and the review of the existing studies, implications for future research include the need for studies to examine the effect of socio-demographic and illness characteristics, patient believes, self-efficacy, subjective norms, and access to care among patients with PH on the treatment adherence. Such research is needed to guide the development of intervention strategies to improve patient adherence and to informed clinicians on ways to address their patient needs.