Evidence map›Paper›PMID 42414013›Full record

ArticleBMJ open2026

Multidimensional correlates of adherence to cardiovascular treatment among patients with multimorbidity from tribal communities in South India: an exploratory cross-sectional study.

Deepa Srinivasan, Maria L Ekstrand, Kavita Singh, Denis Xavier

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Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Deepa SrinivasanDivision of Clinical Research and Training, St John's Research Institute, Bengaluru, Karnataka, India deepa.sn@sjri.res.in.ORCID http://orcid.org/0009-0006-0674-4280
Maria L EkstrandDivision of Mental Health and Neurosciences, St John's Research Institute, Bengaluru, Karnataka, India.
Kavita SinghCentre for Chronic Disease Control, New Delhi, Delhi, India.ORCID http://orcid.org/0000-0003-4330-666X
Denis XavierDepartment of Pharmacology and Division of Clinical Research and Training, St. John's Medical College and Research Institute, Bangalore, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTribal people in India face a growing risk of multimorbidity, primarily from cardiovascular diseases (CVD) due to changing lifestyles and unique socio-cultural and political factors. We aimed to identify treatment patterns and barriers to medication adherence for CVD. This will inform culturally sensitive implementation strategies that may improve outcomes among tribal communities.

methodsWe conducted an exploratory cross-sectional study among participants with multimorbidity in a South-Indian tribal setting. We used a structured questionnaire, guided by the Consolidated Framework for Implementation Research(CFIR), to assess comorbidities, treatment patterns, adherence and potential factors influencing adherence. Descriptive statistics and multivariable logistic regression identified correlates for medication non-adherence.

resultsWe recruited 200 participants with a mean age of 64.6±9.71 years. The majority were female (115, 57.5%), of tribal origin (160, 80%) and had no formal education (169, 84.5%). The commonly reported comorbidities included hypertension (168, 84%) and diabetes (113, 56.5%) followed by chronic kidney disease (CKD) (47, 24%). Self-reported non-adherence to medications (missing at least one CVD pill in the past week) was reported by 120 (60%) participants. Key correlates of non-adherence identified were lower levels of education (OR 8.27, 95% CI 1.96 to 35.01, p=0.004), diabetes (2.94, 95% CI 1.04 to 8.33, p=0.04) and high pill burden (5.04, 95% CI 1.88 to 28.84, p=0.03), while social support (0.85, 95% CI 0.7 to 0.97, p=0.013) and positive illness perception (0.95, 95% CI 0.91 to 0.99, p=0.05) were positively associated with good adherence.

conclusionThese tribal communities face complex challenges in managing CVD and multimorbidity. Improving adherence will require developing simple, patient-centred and culturally appropriate strategies through community engagement. Simplified medication regimens, including rational fixed dose combination pills may improve adherence. Additionally, the high prevalence of CKD observed underscores the need for investigation and integration of regular CKD screening in the health system.

Indexed as

Cardiovascular DiseasesDrug MonitoringMedication AdherenceAgedComorbidityCross-Sectional StudiesFemaleHumansHypertensionIndiaLogistic ModelsMaleMiddle AgedMultimorbiditySurveys and QuestionnairesCardiovascular DiseaseImplementation ScienceIndiaMultimorbidity

Identifiers

PMID42414013
PMCPMC13343025

What Socratic holds

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.