ArticlePatient preference and adherence2021
Exploring Barriers to Medication Adherence Using COM-B Model of Behaviour Among Patients with Cardiovascular Diseases in Low- and Middle-Income Countries: A Qualitative Study.
Article in Patient preference and adherence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Emotional distress, anxiety, and depression in South Asians with long-term conditions: a qualitative systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Pooled it
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- Patient and Carer Understandings and Experiences of Living With Type 2 Diabetes in India.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- What influences the people's trust on public healthcare system in Bihar, India? A mixed methods study.BMC health services research · 2025Article
- Effect of oral health education based on COM-B model on improving the oral health behavior of preschool children.Journal of education and health promotion · 2025Article
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- Accessibility and quality of care for adults with hypertension in rural Burkina Faso: results from a cross-sectional household survey.PLOS global public health · 2025Article
- Barriers and facilitators to viral hepatitis testing in Uzbekistan: scoping qualitative study among key stakeholders, healthcare workers, and the general population.BMC public health · 2024Article
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- Predictors of adherence to prescribed antihypertensive medications among Hypertensive (15-49 years) in India: A secondary data analysis of National Family Health Survey 4.Journal of family medicine and primary care · 2022Article
- Patient engagement to examine perceptions of perinatal depression screening with the capabilities, opportunities, motivation, and behaviors (COM-B) model.Frontiers in health services · 2022Article
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Authors and funding
14 authors at 5 institutions in 4 countries.
Funding
Abstract
introductionIn 2016, cardiovascular diseases (CVDs) led to 17.9 million deaths worldwide, representing 31% of all global deaths. CVDs are the leading cause of mortality worldwide and significant barriers to achieving the sustainable development goals. Modern medicines have been significant in improving health outcomes. However, non-adherence to medication is one of the reasons behind adverse health-related outcomes among patients suffering from atherosclerotic cardiovascular disease in low- and middle-income countries. PATIENTS AND
methodsThis qualitative study was conducted at two tertiary care hospitals in India and Ghana. A total of 35 in-depth interviews were conducted with atherosclerosis cardiovascular disease (ASCVD) patients. The data were analysed thematically using the Capability Opportunity and Motivation (COM-B) framework.
findingsThe findings were summarised under three important broad themes of the COM-B framework: capability, opportunity and behaviour. Under capability, comprehension of disease, medication schedule, and unplanned travel affected adherence among patients. Cost of medication, insurance and access were the critical factors under opportunity, which negatively influenced medication adherence. Mood, beliefs about treatment and outcome expectations under motivation led to non-adherence among patients. Apart from these factors, some important health system factors such as health care experience and trust in the facilities and reliance on alternative medication also affected adherence in both countries.
conclusionThis study has highlighted that the health system factors have dominantly influenced adherence to medication in India and Ghana. In India, we found participants to be satisfied with their health care provided at the government hospitals. However, limited time for consultation, lack of well-stocked pharmacy and unclear prescription negatively influenced adherence among participants in India and Ghana. The study emphasises that the health system needs to be strengthened, and the patients' belief system needs to be explored to address the issue of medication adherence in LMICs.
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