Self-Efficacy Mediates the Relationship Between Depressive Symptoms and Medication Adherence Among Hypertensive African Americans

Abstract

Many studies have documented the negative effects of depression on adherence to recommended treatment; however, little is known about the mechanism underlying this relationship. Using the Kenny and Baron analytic framework of mediation, the authors assessed whether self-efficacy mediated the relationship between depression and medication adherence in 167 hypertensive African Americans followed in a primary care practice. Depressive symptoms are associated with poor medication adherence (beta=.013, p=.036) and low self-efficacy (beta=-.008, p=.023). Self-efficacy is negatively associated with medication adherence at follow-up (beta=-.612, p<.001). The relationship between depressive symptoms and medication adherence becomes nonsignificant when controlling for self-efficacy (beta=.010, p=.087). Implications for further examination into the mediating role of self-efficacy and the deleterious effect of depression on medication adherence are discussed.

Social Support and Adherence to Treatment in Hypertensive Patients: A Meta-Analysis

“…First, all studies included in this quantitative review, except for two [44,56], were cross-sectional. Therefore, it was not possible to advance any causal inference about associations between support and adherence.…”

Association of medication attitudes with non-persistence and non-compliance with medication to prevent fractures

“…Belief in one's ability to carry out a health behavior, or selfefficacy, may also be necessary for that behavior to occur [21][22][23]. Medication-use self-efficacy, the belief or confidence in one's ability to successfully take medication in the context of one's daily life, is associated with medicationuse behavior in rheumatoid arthritis [24], HIV infection [25], and hypertension [26].…”

Practical Approaches to Promote Adherence and Improve Blood Pressure Control in Black Patients

“…Schoenthaler et al examined the relationship of self-effi cacy, depression, and medication adherence in 167 hypertensive AA patients using self-report questionnaires in primary care clinics, and demonstrated that increased self-effi cacy was associated with better medication adherence [ 25 ]. The results also suggested that poor adherence would decrease by 23 % for every one unit increase in self-effi cacy ( P = 0.010).…”