Can Mindfulness Training Improve Medication Adherence? Integrative Review of the Current Evidence and Proposed Conceptual Model.

Elena Salmoirago-Blotcher, Michael P Carey
Author Information
  1. Elena Salmoirago-Blotcher: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02903; The Warren Alpert Medical School of Brown University, Providence, RI; School of Public Health, Brown University, Providence, RI. Electronic address: Elena_Salmoirago-Blotcher@brown.edu.
  2. Michael P Carey: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02903; The Warren Alpert Medical School of Brown University, Providence, RI; School of Public Health, Brown University, Providence, RI.

Abstract

Medication adherence is a complex, multi-determined behavior that is often influenced by system- (e.g., cost), drug- (e.g., regimen complexity), and patient-related (e.g., depression) factors. System-level approaches (e.g., making medications more affordable) are critically important but do not address patient-level factors that can undermine adherence. In this paper, we identify patient-level determinants of non-adherence and discuss whether mindfulness-training approaches that target these determinants can help to improve adherence to medical treatment. We highlight two chronic medical conditions (viz., heart failure and HIV) where poor adherence is a significant concern, and examine the evidence regarding the use of mindfulness interventions to improve medication adherence in these two conditions. We also discuss the theoretical underpinnings of mindfulness training with respect to medication adherence, and conclude by suggesting directions for future research.

Keywords

References

  1. Psychol Sci. 2013 May;24(5):776-81 [PMID: 23538911]
  2. Ann N Y Acad Sci. 2008;1129:305-22 [PMID: 18591490]
  3. JAMA Intern Med. 2014 Mar;174(3):357-68 [PMID: 24395196]
  4. Psychosom Med. 2012 Nov-Dec;74(9):965-73 [PMID: 23115344]
  5. J Card Fail. 2012 Jan;18(1):1-9 [PMID: 22196835]
  6. Circ Heart Fail. 2013 May;6(3):606-19 [PMID: 23616602]
  7. Clin Psychol Rev. 2011 Apr;31(3):449-64 [PMID: 21183265]
  8. Sleep. 1997 Apr;20(4):267-77 [PMID: 9231952]
  9. J Intern Med. 2007 Mar;261(3):268-75 [PMID: 17305649]
  10. N Engl J Med. 2002 Oct 31;347(18):1397-402 [PMID: 12409541]
  11. JAMA. 2001 Mar 21;285(11):1466-74 [PMID: 11255423]
  12. J Clin Psychol. 2006 Mar;62(3):373-86 [PMID: 16385481]
  13. J Gen Intern Med. 2012 Sep;27(9):1159-64 [PMID: 22528619]
  14. Psychosom Med. 2010 Oct;72(8):810-6 [PMID: 20716711]
  15. AIDS Behav. 2012 Nov;16(8):2119-43 [PMID: 22644066]
  16. Psychol Bull. 2003 Sep;129(5):674-697 [PMID: 12956539]
  17. Nurs Clin North Am. 2008 Mar;43(1):133-53; vii-viii [PMID: 18249229]
  18. J Am Coll Cardiol. 2004 Jun 2;43(11):2036-43 [PMID: 15172409]
  19. Clin Nurs Res. 2014 Jun;23(3):231-44 [PMID: 23548500]
  20. J Card Fail. 2008 Apr;14(3):203-10 [PMID: 18381183]
  21. AIDS Behav. 2011 Oct;15(7):1381-96 [PMID: 21468660]
  22. J Urban Health. 2014 Feb;91(1):151-61 [PMID: 23749458]
  23. Sex Health. 2007 Dec;4(4):227-32 [PMID: 18082064]
  24. Cogn Behav Ther. 2009;38 Suppl 1:15-20 [PMID: 19697176]
  25. LGBT Health. 2014 Dec;1(4):319-22 [PMID: 26789859]
  26. Circ Cardiovasc Qual Outcomes. 2009 Sep;2(5):407-13 [PMID: 20031870]
  27. N Engl J Med. 1998 Mar 26;338(13):853-60 [PMID: 9516219]
  28. Front Neurosci. 2013 Feb 04;7:8 [PMID: 23382709]
  29. J Card Fail. 2011 Apr;17(4):340-8 [PMID: 21440873]
  30. Psychol Bull. 2009 Sep;135(5):707-730 [PMID: 19702379]
  31. Heart Lung. 2012 Nov-Dec;41(6):572-82 [PMID: 22784869]
  32. Acta Oncol. 2013 Feb;52(2):336-44 [PMID: 23282113]
  33. Ann Behav Med. 2008 Jun;35(3):331-40 [PMID: 18535870]
  34. MMWR Morb Mortal Wkly Rep. 2014 Nov 28;63(47):1113-7 [PMID: 25426654]
  35. J Acquir Immune Defic Syndr. 2011 Oct 1;58(2):181-7 [PMID: 21857529]
  36. AIDS. 2008 Jul 11;22(11):1345-54 [PMID: 18580614]
  37. Annu Rev Neurosci. 1995;18:193-222 [PMID: 7605061]
  38. Circ Heart Fail. 2012 Jul 1;5(4):414-21 [PMID: 22556322]
  39. Eur J Clin Pharmacol. 2001 Apr;57(1):77-83 [PMID: 11372597]
  40. J Psychosom Res. 2010 Jun;68(6):539-44 [PMID: 20488270]
  41. Clin Psychol Rev. 2016 Apr;45:102-14 [PMID: 27111302]
  42. Circulation. 2015 Jan 27;131(4):e29-322 [PMID: 25520374]
  43. J Alzheimers Dis. 2010;20(2):517-26 [PMID: 20164557]
  44. JAMA. 2004 Jul 21;292(3):344-50 [PMID: 15265849]
  45. Circulation. 2013 Oct 15;128(16):e240-327 [PMID: 23741058]
  46. Health Psychol. 1993 Mar;12(2):93-102 [PMID: 8500445]
  47. Am J Health Syst Pharm. 2004 Oct 1;61(19):2043-9 [PMID: 15509127]
  48. Am J Med. 2004 Jul 15;117(2):73-81 [PMID: 15234641]
  49. Circ Heart Fail. 2011 Jul;4(4):396-403 [PMID: 21562056]
  50. Ann Behav Med. 2011 Dec;42(3):352-60 [PMID: 21818528]
  51. Psychother Psychosom. 2012;81(5):296-304 [PMID: 22832540]
  52. BMJ. 2003 Jun 28;326(7404):1419 [PMID: 12829553]
  53. J Consult Clin Psychol. 2010 Apr;78(2):169-83 [PMID: 20350028]
  54. Explore (NY). 2011 Mar-Apr;7(2):76-87 [PMID: 21397868]
  55. Wien Klin Wochenschr. 2003 Nov 28;115(21-22):758-66 [PMID: 14743579]
  56. J Pain Symptom Manage. 2012 Feb;43(2):161-71 [PMID: 21925831]
  57. Annu Rev Neurosci. 2001;24:167-202 [PMID: 11283309]
  58. Conscious Cogn. 2009 Mar;18(1):176-86 [PMID: 19181542]
  59. Explore (NY). 2014 May-Jun;10(3):180-6 [PMID: 24767265]
  60. Dev Psychol. 2014 Jul;50(7):1910-8 [PMID: 24730378]
  61. Am J Manag Care. 2009 Jul;15(7):437-45 [PMID: 19589011]
  62. PLoS One. 2014 Mar 24;9(3):e92842 [PMID: 24663122]
  63. J Neurosci. 2009 Jul 8;29(27):8726-33 [PMID: 19587279]
  64. Circ Heart Fail. 2012 Jul 1;5(4):430-6 [PMID: 22647773]
  65. J Gen Intern Med. 2011 Oct;26(10):1175-82 [PMID: 21533823]
  66. Heart Lung. 2010 Sep-Oct;39(5):378-85 [PMID: 20561849]
  67. Emotion. 2010 Feb;10(1):54-64 [PMID: 20141302]
  68. Circulation. 2013 Jan 1;127(1):143-52 [PMID: 23283859]
  69. Clin Infect Dis. 2013 Oct;57(8):1164-71 [PMID: 23797289]
  70. Eur J Prev Cardiol. 2015 Nov;22(11):1385-98 [PMID: 25227551]
  71. PLoS One. 2014 Apr 24;9(4):e96110 [PMID: 24763812]
  72. J Exp Psychol Hum Percept Perform. 1990 Feb;16(1):121-34 [PMID: 2137514]
  73. Clin Infect Dis. 2007 Jun 1;44(11):1493-9 [PMID: 17479948]
  74. BMC Med. 2014 Aug 21;12:142 [PMID: 25145556]
  75. Health Soc Work. 2004 Nov;29(4):275-85 [PMID: 15575455]
  76. Neuropsychobiology. 2013;68(1):34-43 [PMID: 23774986]
  77. J Clin Sleep Med. 2008 Feb 15;4(1):38-42 [PMID: 18350960]
  78. Menopause. 2011 Jun;18(6):611-20 [PMID: 21372745]
  79. Clin Nurs Res. 2012 Aug;21(3):271-93 [PMID: 21878581]
  80. Curr HIV/AIDS Rep. 2014 Sep;11(3):291-307 [PMID: 25038748]
  81. J Psychosom Res. 2008 Apr;64(4):405-8 [PMID: 18374739]
  82. J Acquir Immune Defic Syndr. 2002 Dec 15;31 Suppl 3:S136-9 [PMID: 12562037]
  83. J Behav Med. 2014 Feb;37(1):166-72 [PMID: 23180286]
  84. Curr Cardiol Rep. 2015 Dec;17(12):112 [PMID: 26482755]
  85. Arch Intern Med. 2008 Feb 25;168(4):418-24 [PMID: 18299498]
  86. J Behav Med. 2008 Feb;31(1):23-33 [PMID: 17899351]
  87. Cardiol Res Pract. 2012;2012:631075 [PMID: 22928145]
  88. J Card Fail. 2011 Aug;17(8):664-9 [PMID: 21807328]

Grants

  1. R34 AT008930/NCCIH NIH HHS

MeSH Term

Anti-HIV Agents
Cognitive Dysfunction
Depression
HIV Infections
Heart Failure
Humans
Medication Adherence
Mindfulness
Models, Theoretical
Sleep Wake Disorders
Stress, Psychological

Chemicals

Anti-HIV Agents

Word Cloud

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