Purpose: To examine factors that facilitate an understanding of the relationship between two important, and often interchangeably used, concepts in diabetes management: compliance and adherence.
Design: A cross-sectional survey.
Setting: Online data collection.
Subjects: 365 respondents at least 18 years of age and currently in treatment for diabetes.
Measures: We measured patients' compliance, adherence, mindfulness, and perceptions about physician-patient communication, as well as their demographic characteristics.
Analysis: A moderated mediation analysis was conducted to examine the conditioned indirect effect of compliance on adherence.
Results: The direct effect of compliance on adherence was positive and significant (β = .378, SE = .073, P < .05, BootCI [.234, .521]), but the compliance-adherence association was also partially mediated by patient's potential for mindful non-adherence. A higher level of compliance increased potential for mindful non-adherence (β = .716, SE = .082, P < .05, BootCI [.555, .876]), and, in turn, the increased potential for mindful non-adherence reduced adherence (β = -.107, SE = .045, P < .05, BootCI [-.196, -.018]). This detrimental mediating effect of potential for mindful non-adherence was contingent on the perceived quality of physician-patient communication (index = .076, SE = .038, 95% BootCI [.003, .153]), indicating that the positive perception significantly reduced the negative mediating effect of potential for mindful non-adherence on adherence.
Conclusion: Given that patients with diabetes are involved in a complex self-care, an established partnership and collaboration between patient and doctor is essential to promoting adherence; when the treatment coincides with the patient's beliefs and needs, mindful non-adherence is less likely to occur.
Keywords: compliance; diabetes care; mindful non-adherence; moderated mediation; patient adherence; physician-patient communication.