Conscientiousness and Medication Adherence: A Meta-analysis

BackgroundApproximately a quarter to a half of all people fail to take their medication regimen as prescribed (i.e. non-adherence). Conscientiousness, from the five-factor model of personality, has been positively linked to adherence to medications in several recent studies.PurposeThis study aimed to systematically estimate the strength and variability of this association across multiple published articles and to identify moderators of this relationship.MethodA literature search identified 16 studies (N = 3,476) that met the study eligibility criteria. Estimates of effect sizes (r) obtained in these studies were meta-analysed.ResultsOverall, a higher level of conscientiousness was associated with better medication adherence (r = 0.15; 95 % CI, 0.09, 0.21). Associations were significantly stronger in younger samples (r = 0.26, 95 % CI, 0.17, 0.34; k = 7).ConclusionThe small association between conscientiousness and medication adherence may have clinical significance in contexts where small differences in adherence result in clinically important effects.

[1]  Malin Axelsson,et al.  The Influence of Personality Traits on Reported Adherence to Medication in Individuals with Chronic Disease: An Epidemiological Study in West Sweden , 2011, PloS one.

[2]  Wilhelm Hofmann,et al.  Everyday temptations: an experience sampling study of desire, conflict, and self-control. , 2012, Journal of personality and social psychology.

[3]  Brent W. Roberts,et al.  Conscientiousness and Health across the Life Course , 2005 .

[4]  L. Osterberg,et al.  Adherence to medication. , 2005, The New England journal of medicine.

[5]  B. Roberts,et al.  Conscientiousness and health-related behaviors: a meta-analysis of the leading behavioral contributors to mortality. , 2004, Psychological bulletin.

[6]  J. Nigg,et al.  A person-centered personality approach to heterogeneity in attention-deficit/hyperactivity disorder (ADHD). , 2010, Journal of abnormal psychology.

[7]  K Torén,et al.  Personality, adherence, asthma control and health-related quality of life in young adult asthmatics. , 2009, Respiratory medicine.

[8]  R. Haynes,et al.  Interventions for enhancing medication adherence. , 2008, The Cochrane database of systematic reviews.

[9]  Jacob Cohen,et al.  A power primer. , 1992, Psychological bulletin.

[10]  Joshua J. Jackson,et al.  Sociogenomic personality psychology. , 2008, Journal of personality.

[11]  N. Schneiderman,et al.  Personality, quality of life and HAART adherence among men and women living with HIV/AIDS. , 2003, Journal of psychosomatic research.

[12]  J. Bargh,et al.  Nonconscious processes and health. , 2013, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[13]  M. Robin DiMatteo,et al.  Patient Adherence and Medical Treatment Outcomes: A Meta-Analysis , 2002, Medical care.

[14]  A. Christensen,et al.  Assessment of irrational health beliefs: relation to health practices and medical regimen adherence. , 1999, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[15]  B. Roberts,et al.  The role of adherence in the relationship between conscientiousness and perceived health. , 2011, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[16]  D. Au,et al.  The Influence of Informal Caregivers on Adherence in COPD Patients , 2012, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[17]  Joshua J. Jackson,et al.  Compensatory Conscientiousness and Health in Older Couples , 2009, Psychological science.

[18]  B. Roberts,et al.  Conscientiousness and longevity: an examination of possible mediators. , 2011, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[19]  P Kuppens,et al.  Categories versus dimensions in personality and psychopathology: a quantitative review of taxometric research , 2011, Psychological Medicine.

[20]  Sidney H Kennedy,et al.  The 5-Factor Model of Personality and Antidepressant Medication Compliance , 2004, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[21]  M. Dimatteo,et al.  Health Beliefs, Disease Severity, and Patient Adherence: A Meta-Analysis , 2007, Medical care.

[22]  R. DeRubeis,et al.  Personality change during depression treatment: a placebo-controlled trial. , 2009, Archives of general psychiatry.

[23]  S. De Geest,et al.  Adherence to Long-Term Therapies: Evidence for Action , 2003, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[24]  C. Sudlow,et al.  Predictors of Adherence to Secondary Preventive Medication in Stroke Patients , 2011, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[25]  Susanne M. Jaeggi,et al.  Influence of neuroticism and conscientiousness on working memory training outcome , 2012 .

[26]  C. L. Rose,et al.  The role of the Big Five personality factors in vigilance performance and workload , 2002 .

[27]  M. Conner,et al.  Exploring the Benefits of Conscientiousness: An Investigation of the Role of Daily Stressors and Health Behaviors , 2009, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[28]  David M Cutler,et al.  Thinking outside the pillbox--medication adherence as a priority for health care reform. , 2010, The New England journal of medicine.

[29]  R. Baumeister,et al.  Self-control and its relation to emotions and psychobiology: evidence from a Day Reconstruction Method study , 2014, Journal of Behavioral Medicine.

[30]  B. Roberts,et al.  The Case for Conscientiousness: Evidence and Implications for a Personality Trait Marker of Health and Longevity , 2013, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[31]  Kathleen C Insel,et al.  The Negative Association of Independent Personality and Medication Adherence , 2006, Journal of aging and health.

[32]  M. Dimatteo,et al.  Social support and patient adherence to medical treatment: a meta-analysis. , 2004, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[33]  W. Cushman,et al.  Antihypertensive Medication Adherence, Ambulatory Visits, and Risk of Stroke and Death , 2010, Journal of General Internal Medicine.

[34]  D. Rutter,et al.  Adherence to anti-hypertensive medication: proposing and testing a conceptual model. , 2012, British journal of health psychology.

[35]  Jared M. Bruce,et al.  Treatment adherence in multiple sclerosis: association with emotional status, personality, and cognition , 2010, Journal of Behavioral Medicine.

[36]  K. Raichle,et al.  Patient personality and mortality: a 4-year prospective examination of chronic renal insufficiency. , 2002, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[37]  E. Ferguson Personality is of central concern to understand health: towards a theoretical model for health psychology , 2013, Health psychology review.

[38]  Jordan B Peterson,et al.  Between facets and domains: 10 aspects of the Big Five. , 2007, Journal of personality and social psychology.

[39]  D. Kahneman,et al.  Would You Be Happier If You Were Richer? A Focusing Illusion , 2006, Science.

[40]  P. Fletcher,et al.  Changing Human Behavior to Prevent Disease: The Importance of Targeting Automatic Processes , 2012, Science.

[41]  Joshua J. Jackson,et al.  Mechanisms of health: Education and health-related behaviours partially mediate the relationship between conscientiousness and self-reported physical health , 2010, Psychology & health.

[42]  D. Johnston,et al.  A Taxometric Analysis of Type-D Personality , 2009, Psychosomatic medicine.

[43]  G. Matthews,et al.  Individual differences in attentional networks: Trait and state correlates of the ANT , 2012 .

[44]  Henry L. Tosi,et al.  Effort, Performance, and Conscientiousness: An Agency Theory Perspective , 2007 .

[45]  M. Dimatteo,et al.  Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. , 2000, Archives of internal medicine.

[46]  M. Dimatteo Variations in Patients’ Adherence to Medical Recommendations: A Quantitative Review of 50 Years of Research , 2004, Medical care.

[47]  Matthew F. Muldoon,et al.  Psychological and cognitive function: Predictors of adherence with cholesterol lowering treatment , 2004, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[48]  C. Sudlow,et al.  Improving Adherence to Medication in Stroke Survivors: A Pilot Randomised Controlled Trial , 2013, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[49]  J. Cramer,et al.  A systematic review of the associations between dose regimens and medication compliance. , 2001, Clinical therapeutics.

[50]  Timothy W. Smith,et al.  Personality and patient adherence: Correlates of the five-factor model in renal dialysis , 1995, Journal of Behavioral Medicine.

[51]  A. Steptoe,et al.  Type D Personality, Self-Efficacy, and Medication Adherence Following an Acute Coronary Syndrome , 2012, Psychosomatic medicine.

[52]  Haynes Rb,et al.  Interventions for enhancing medication adherence (Review) , 2008 .

[53]  H. Friedman,et al.  Long-term relations of personality and health: dynamisms, mechanisms, tropisms. , 2000, Journal of personality.

[54]  L. Hedges,et al.  Introduction to Meta‐Analysis , 2009, International Coaching Psychology Review.

[55]  M. Kivimaki,et al.  Low conscientiousness and risk of all-cause, cardiovascular and cancer mortality over 17 years: Whitehall II cohort study. , 2012, Journal of psychosomatic research.

[56]  S. Srivastava,et al.  The Big Five Trait taxonomy: History, measurement, and theoretical perspectives. , 1999 .

[57]  A. Davenport,et al.  Non-adherence to Immunosuppressive Medications in Kidney Transplantation: Intent Vs. Forgetfulness and Clinical Markers of Medication Intake , 2012, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[58]  M. Mcmurdo,et al.  Interventions to Enhance Adherence to Medications in Patients With Heart Failure: A Systematic Review , 2012, Circulation. Heart failure.

[59]  A. Jerant,et al.  Personality and medication non-adherence among older adults enrolled in a six-year trial. , 2011, British journal of health psychology.

[60]  Robert Gross,et al.  The influence of patient adherence on anticoagulation control with warfarin: results from the International Normalized Ratio Adherence and Genetics (IN-RANGE) Study. , 2007, Archives of internal medicine.

[61]  F. Strack,et al.  Reflective and Impulsive Determinants of Social Behavior , 2004, Personality and social psychology review : an official journal of the Society for Personality and Social Psychology, Inc.

[62]  L. Lix,et al.  Predictors of Medication Adherence in Inflammatory Bowel Disease , 2007, The American Journal of Gastroenterology.

[63]  C. Abraham,et al.  A taxonomy of behavior change techniques used in interventions. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[64]  Eric D. Heggestad,et al.  Intelligence, personality, and interests: evidence for overlapping traits. , 1997, Psychological bulletin.

[65]  D. Umberson,et al.  Gender, marital status and the social control of health behavior. , 1992, Social science & medicine.

[66]  Gail Ironson,et al.  Conscientiousness predicts disease progression (CD4 number and viral load) in people living with HIV. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[67]  H. Friedman,et al.  Personality and mortality risk across the life span: the importance of conscientiousness as a biopsychosocial attribute. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[68]  Marie T. Brown,et al.  Medication adherence: WHO cares? , 2011, Mayo Clinic proceedings.

[69]  F. Dobbels,et al.  Prevalence and Correlates of Self-Reported Pretransplant Nonadherence with Medication in Heart, Liver, and Lung Transplant Candidates , 2005, Transplantation.

[70]  P. Sheeran,et al.  Enhancing antiepileptic drug adherence: A randomized controlled trial , 2009, Epilepsy & Behavior.

[71]  Urte Scholz,et al.  The role of action control in implementing intentions during the first weeks of behaviour change. , 2006, The British journal of social psychology.

[72]  H. Friedman,et al.  Does childhood personality predict longevity? , 1993, Journal of personality and social psychology.

[73]  K. Wallston,et al.  Patient and Physician Beliefs About Control over Health: Association of Symmetrical Beliefs with Medication Regimen Adherence , 2010, Journal of General Internal Medicine.

[74]  C. Abraham,et al.  The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions , 2013, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[75]  Ulrich Trautwein,et al.  Military Training and Personality Trait Development , 2012, Psychological science.

[76]  M. Johnston,et al.  The Best Laid Plans: Planning Skill Determines the Effectiveness of Action Plans and Implementation Intentions , 2013, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[77]  Jerry L. Grenard,et al.  Depression and Medication Adherence in the Treatment of Chronic Diseases in the United States: A Meta-Analysis , 2011, Journal of General Internal Medicine.

[78]  E. Ferguson A taxometric analysis of health anxiety , 2008, Psychological Medicine.

[79]  A. Christensen,et al.  Health beliefs, personality, and adherence in hemodialysis patients: An interactional perspective , 1997, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[80]  A. Christensen,et al.  Social support and conscientiousness in hemodialysis adherence , 1997, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[81]  H. McGee,et al.  The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality. , 2006, Journal of psychosomatic research.

[82]  Martin S. Hagger,et al.  Influences of personality traits and continuation intentions on physical activity participation within the theory of planned behaviour , 2008, Psychology & health.

[83]  S. Woods,et al.  The role of prospective memory in medication adherence: a review of an emerging literature , 2011, Journal of Behavioral Medicine.