Increasing Adherence to Treatment Regimens for Ethnic Minorities Affected by Cardiovascular Disease in High Income Countries: The Role of Mind-Body-Interventions

Abstract

Background: Adherence to treatment regimens is vital for the control and management for CVDs. Yet only 40-60% of patients adhere to their treatment plan, increasing the likelihood of adverse cardiac events, re-hospitalization or even death. The symptom burden of CVD’s, low self-efficacy, and lacking confidence in foreign health systems makes patients from ethnic minority groups (EMG) especially vulnerable to low adherence. As current interventions to address low adherence have fallen short of effective long-term increases, Mind-Body-Interventions (MBI) might provide a novel secondary prevention approach to close this gap. The aim of this desk review was to shed light on whether MBIs have the potential to increase adherence in EMG in high income countries diagnosed with CVD. Method: A systematic literature search has been conducted using MEDLINE, CINAHL, and PsychINFO databases. In total, 17 studies have been critically reviewed. Results: Findings for EMGs are poor, however, evidence for the general population demonstrated predominantly positive effects of MBIs on adherence, self-efficacy, health outcomes, and quality of life. Yet, heterogeneous study design and methodology prohibits the generalizability of evidence. Conclusion: Overall, the evidence present encouraging findings on the potential of MBIs to increase adherence in the general population. Nonetheless, further research is warranted to investigate whether this holds true for EMGs. Moreover, research should consider potential cultural implications in EMGs and address the lacking consensus in the operationalization of adherence and MBI. Keywords: Adherence, Self-efficacy, Cardiovascular-Disease, Mind-Body-Intervention, Ethnic-Minorities