Determinants of medication adherence among Iranian patients with type 2 diabetes: An application of health action process approach

Soheila Ranjbaran; Davoud Shojaeizadeh; Tahereh Dehdari; Mehdi Yaseri; Elham Shakibazadeh

doi:10.1016/j.heliyon.2020.e04442

Determinants of medication adherence among Iranian patients with type 2 diabetes: An application of health action process approach

Heliyon. 2020 Jul 14;6(7):e04442. doi: 10.1016/j.heliyon.2020.e04442. eCollection 2020 Jul.

Authors

Soheila Ranjbaran¹, Davoud Shojaeizadeh¹, Tahereh Dehdari², Mehdi Yaseri³, Elham Shakibazadeh¹

Affiliations

¹ Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
² Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.
³ Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

To identify determinants of medication adherence among patients with type 2 diabetes based on the health action process approach. This cross-sectional study was conducted among 734 patients with type 2 diabetes attending to south Tehran health centers during June to December 2018. Data were gathered using the Morisky Medication Adherence Scale (MMAS-8-Item) and the health action process approach questionnaire. We used Mann-Whitney, Pearson Chi-Squared, Fisher's Exact and Independent Samples Tests for comparison of adherence medication by demographic characteristics; and linear regression analysis to predict factors related to medication adherence based on HAPA. P-value less than 0.05 considered statistically significant. A total of 232 men and 502 women participated in the study, Mean age was 61.61 ± 9.74. Most participants (82.3%) reported low medication adherence (females: 68.4%). Medication adherence was significantly associated with gender (p = 0.03). Medication adherence was significantly predicted by intention (β = 0.172, p = 0.0001), task self-efficacy (β = 0.172, p = 0.01), copping planning (β = 0.6, p = 0.0001) and copping self-efficacy (β = -0.244, p = 0.001). The level of adherence to medications among type 2 diabetes patients was low. The behavior intention, task self-efficacy, copping planning and copping self-efficacy were significant determinants contributed to the medication adherence. HAPA inventory includes various factors, especially types of self-efficacy. Thus, utilization of this comprehensive model in interventional studies is suggested. These determinants should be considered in developing interventional programs to improve adherence.

Keywords: Determinants; Diabetes; Diet; Health action process approach; Health profession; Health promotion; Health sciences; Insulin; Iran; Medication adherence; Type 2 diabetes.