Evaluation of medication beliefs and social determinants health among Albanian with chronic diseases

Background

People’s beliefs and attitudes toward medicines substantially influence their health decisions, particularly whether they adhere to prescribed medications. Cognitive and emotional beliefs are among the most reliable predictors of adherence across multiple treatments and diseases.

Methods

After the Evaluation of the Albanian Version of the Beliefs About Medicines Questionnaire (BMQ-General), the association between beliefs about medicines (harm, overuse, and benefit) and social determinants of health (SDH) was analysed in a sample of 240 adults diagnosed with hypertension and/or diabetes. Regression analyses were performed to assess how SDH may relate to beliefs about medicines.

Results

Sociodemographic and behavioral factors showed a stronger association with negative beliefs about medicines (harm and overuse), rather than positive beliefs (benefit). The use of alternative medicine emerged as a consistent predictor across models, being associated with higher perceived harm and higher overuse beliefs. Lower education level was also associated with higher harm perceived about medicine. However, a higher number of medication intake and not living alone are associated with lower harm perception of medicines. A higher medication intake frequency per day, a rural residency, not going to periodic medical check-ups, and not being enrolled in the healthcare insurance process are associated with higher overuse beliefs about medicines. In contrast, Benefit beliefs were weakly explained by the included variables. No consistent associations were observed for age, gender, or most socioeconomic variables across the models.

Conclusions

Social determinants may shape medication beliefs, especially negative perceptions. Addressing education, healthcare engagement, and alternative medicine use may improve adherence, reduce mistrust, and guide targeted, effective interventions for chronic disease management.

Key messages

• Improving education, healthcare engagement, and addressing alternative medicine use may strengthen adherence and reduce mistrust in chronic disease treatment.

• Social and behavioral factors are related to beliefs about medicines, especially harm and overuse perceptions.