Self-Efficacy as Moderator and Mediator Between Medication Beliefs and Adherence in Elderly Patients with Type 2 Diabetes

• Published in: Patient preference and adherence Vol. 17; pp. 217 - 226
• Main Authors: Wu, Jianbo, Shen, Jie, Tao, Zhujun, Song, Zhongjuan, Chen, Zhi-Long
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2023; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Activities of daily living; Aged patients; Antidiabetics; Diabetes; Drug therapy; elderly patients; Ethics; Health attitudes; Hospital patients; Hospitals; Intervening variables; Likert scale; mediation effect; medication adherence; medication belief; moderation effect; Older people; Original Research; Patient compliance; Psychological aspects; Quantitative psychology; Questionnaires; Self-efficacy; Self-efficacy (Psychology); Sociodemographics; Surveys; Type 2 diabetes; China; medication belief; elderly patients; mediation effect; medication adherence; moderation effect; self-efficacy
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/PPA.S382362

Poor antidiabetic medication adherence remains a great barrier to effective diabetes self-management among aging adults. This study investigates the mediation and moderation effects of self-efficacy on the relationship between medication beliefs and adherence in elderly patients with type 2 diabetes. This cross-sectional study evaluated a sample of 309 hospitalized elderly patients who completed the assessment of medication beliefs, self-efficacy for medication uses and medication adherence in a tertiary hospital in Shanghai, China. A bootstrapping sampling method and hierarchical moderator regression analysis were used to verify the hypothesis of mediation and moderation effects of self-efficacy on the relationship between medication beliefs and adherence. Self-efficacy for medication use acted as a moderator ( =-0.063, =-2.215, =0.028) and partial mediator (CI =4.5-16.63, =0.001; CI =1.524-5.323, =0.014; CI =2.151-11.817, =0.001) on the relationship between general harm medication beliefs and medication adherence. Participants with lower general harm medication beliefs may develop higher self-efficacy, which, in turn, results in a higher level of medication adherence, and higher self-efficacy may attenuate the negative effect of high general harm medication beliefs on medication adherence. Self-efficacy for medication use not only mediated the relationship between general harm beliefs about medication and medication adherence, but moderated it negatively. The findings of this study indicate an opportunity to improve the prognosis of elderly Chinese patients with type 2 diabetes through improved medication adherence by strengthening factors such as self-efficacy for appropriate medication use and general harm beliefs about medication.