Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

Abstract

PurposeThe objective of this study was to identify, using the theory of planned behavior (TPB), patients’ beliefs about taking oral antidiabetic drugs (OADs) as prescribed, and to measure the correlations between beliefs and medication adherence.Patients and methodsWe performed a cross-sectional study of type 2 diabetic patients using structured questionnaires in a Chinese tertiary hospital. A total of 130 patients were enrolled to be interviewed about TPB variables (behavioral, normative, and control beliefs) relevant to medication adherence. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8). Spearman’s rank correlation was used to assess the association between TPB and MMAS-8. Logistic regression analysis was performed to examine the relationship between different variables and MMAS-8, with statistical significance determined at P<0.05.ResultsFrom 130 eligible Chinese patients with an average age of 60.6 years and a male proportion of 50.8%, a nonsignificant relationship between behavioral, normative, and the most facilitating control beliefs and OAD adherence was found in our study. Having the OADs on hand (P=0.037) was the only facilitating control belief associated with adherence behavior. Being away from home or eating out (P=0.000), not accepting the disease (P=0.000), ignorance of life-long drug adherence (P=0.038), being busy (P=0.001), or poor memory (P=0.008) were control belief barriers found to be correlated with poor adherence. TPB is the only important determinant influencing OAD adherence among all the factors (P=0.011).ConclusionThe results indicate that the TPB model could be used to examine adherence to OADs. One facilitating control belief, and most of the barrier control beliefs of TPB were related to medication adherence among Chinese type 2 diabetes inpatients. It will be helpful to understand patients’ self-medication and provide methods to develop instruments for identifying factors that influence OAD adherence.

Beliefs related to oral antidiabetic use among individuals with diabetes

“…In relation to the disadvantages, the most salient belief categorized as unfavorable to the use of the tablets, was pain and gastric discomfort, nausea and diarrhea. Similar beliefs of adverse effects to the use of OAD emerged in previous research studies, with a higher frequency to the one in this study, (57.7%) 3 and (82.4%). 8 Most of the drugs in the tablet composition for T2DM have benefits because they reduce glycated hemoglobin, without risks of hypoglycemia with weight loss.…”

“…In previous studies similar beliefs were obtained. 3,8 The individuals' confidence in the established pharmacological therapy lies in obtaining controlled blood sugar levels, in the time flexibility for taking the OADs and in Beliefs about oral antidiabetic use Gouveia BLA, Sousa MM, Almeida TCF, Sousa VAG, Pereira WDF, Oliveira SHS the absence or decrease of the disease symptoms such as polyphagia, weight loss, excessive thirst, frequent urination, malaise, and headache, among others. 15 The belief identified as the advantage of "not needing to use insulin" when taking the OADs correctly points to the fear of individuals with T2DM in relation to injectable treatment.…”

“…2 However, evidence points to low adherence of people with T2DM in following the established medication therapy. 3,4 Low or non-adherence to the treatment of chronic diseases such as diabetes ranges from 6% to 55%. 5 The literature shows that individuals with lower schooling and younger people present an ineffective adherence to the treatment.…”

“…Factors like adverse reactions, treatment complexity, acute crises of hypoglycemia, high costs of medications, weaknesses in the medication dispensing policy, forgetfulness and difficulties in comprehending the prescription are pointed out as obstacles to therapeutic adherence. 3,[8][9][10] Considering the relevance of oral therapy follow-up for controlling the metabolism and the disease, it is important to develop health care technologies which benefit and implement self-care actions, supported by theoretical models. From this perspective, the Theory of Planned Behavior (TPB) has been applied to identify, explain and indicate the predictors of behavior in specific contexts.…”

An Evaluation of Medication Adherence in Tuberculosis Patients Based on Theory of Planned Behavior

“…The aim of this study was to identify factors that affect the medication adherence of TB patients based on Theory of Planned Behavior. The results of the study showed that the main factors of TPB (such as ATB, SN, and PBC) explain more than 96% of the other studies have also suggested that TPB became positive determinant factor related to adherence (Wu and Liu, 2016), TPB was also helpful to investigate factors underlying medication adherence (Bérubé et al, 2017), so that TPB can be used as powerful tool to predict intention and medication adherence (Zomahoun et al, 2016).…”