Abstract
Poor medication adherence is a leading cause of excessive cardiovascular morbidity among African Americans. Many adherence-promoting
interventions have addressed economic barriers, improved the patient-provider relationship, simplified regimens, and used
reminder systems; however, the problem of low adherence remains intractable. Meanwhile, positive psychological attributes
that might serve to promote medication adherence have not been fully explored. To address this gap, we examined the association
between happiness and medication adherence among low-income African Americans with hypertension treated in a safety-net setting.
Data were obtained from the Alabama Collaboration for Cardiovascular Equality, 2007–2008. Happiness was measured using the
4-item scale of Lyubomirsky and Lepper; low, moderate, and high happiness were defined by tertiles because of the non-normal
distribution. Medication adherence was assessed with the Morisky Medication Adherence Scale. Associations were quantified
with ordinal logistic regression. Our sample of 573 African Americans was 71.6 % female and had an average age ± SD of 53.6 ± 9.7 years
and a median happiness score of 5.2. Compared to participants with low happiness, the odds (OR; 95 % CI) of being in a better
medication adherence category were greater for those with moderate (1.53; 1.02–2.27) and high (2.26; 1.52-3.37) happiness,
after adjusting for age, sex, income, education, and difficulty paying for medical care. Within this cohort of low-income
African Americans with hypertension, participants with greater happiness exhibited better medication adherence. Although one
interpretation of our study is that more adherent patients are naturally happier, our findings raise the possibility that
adding happiness-boosting components may increase the effectiveness of more traditional adherence interventions.
interventions have addressed economic barriers, improved the patient-provider relationship, simplified regimens, and used
reminder systems; however, the problem of low adherence remains intractable. Meanwhile, positive psychological attributes
that might serve to promote medication adherence have not been fully explored. To address this gap, we examined the association
between happiness and medication adherence among low-income African Americans with hypertension treated in a safety-net setting.
Data were obtained from the Alabama Collaboration for Cardiovascular Equality, 2007–2008. Happiness was measured using the
4-item scale of Lyubomirsky and Lepper; low, moderate, and high happiness were defined by tertiles because of the non-normal
distribution. Medication adherence was assessed with the Morisky Medication Adherence Scale. Associations were quantified
with ordinal logistic regression. Our sample of 573 African Americans was 71.6 % female and had an average age ± SD of 53.6 ± 9.7 years
and a median happiness score of 5.2. Compared to participants with low happiness, the odds (OR; 95 % CI) of being in a better
medication adherence category were greater for those with moderate (1.53; 1.02–2.27) and high (2.26; 1.52-3.37) happiness,
after adjusting for age, sex, income, education, and difficulty paying for medical care. Within this cohort of low-income
African Americans with hypertension, participants with greater happiness exhibited better medication adherence. Although one
interpretation of our study is that more adherent patients are naturally happier, our findings raise the possibility that
adding happiness-boosting components may increase the effectiveness of more traditional adherence interventions.
- Content Type Journal Article
- Pages 1-10
- DOI 10.1007/s11482-012-9170-1
- Authors
- Yendelela L. Cuffee, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655-0002, USA
- Erik Angner, Department of Philosophy, George Mason University, Fairfax, VA, USA
- Norman Oliver, Department of Family Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
- Deborah Plummer, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
- Catarina Kiefe, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655-0002, USA
- Sandral Hullett, Cooper Green Mercy Hospital, Birmingham, AL, USA
- Jeroan Allison, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655-0002, USA
- Journal Applied Research in Quality of Life
- Online ISSN 1871-2576
- Print ISSN 1871-2584