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Medication adherence and predictive factors among patients with rheumatoid arthritis: A COM-B model guided structural
Guilan Gong1, Anhong Dong2, Zeyu Zhang3
1School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Objective:
To assess medication adherence of patients with rheumatoid arthritis (RA) and explore predictive factors under the guidance of the Capability, Opportunity and Motivation to Behavior (COM-B) model.
Methods:
A cross-sectional study was conducted among 221 RA patients conveniently recruited from rheumatology outpatient clinics of a university-affiliated hospital in China. Data about patients' sociodemographic and disease characteristics, medication adherence, functional disability, social support, beliefs about medicines, self-efficacy, and depression were collected via self-administered questionnaires. The influence of factors within the COM-B model on medication adherence were analyzed by the structural equation model.
Results:
The mean score of medication adherence was 63.19 (SD 8.83), and 214 participants (96.8%) were considered non-adherent to their medication regime. Greater functional disability, higher social support, more positive beliefs about medicines, higher self-efficacy, and lower depression were significantly positively associated directly or indirectly with medication adherence, explaining 66% of the total variance.
Conclusion:
Patients with RA demonstrate poor medication adherence. Essentials in improving medication adherence are delaying the occurrence of disability, promoting social support, shaping beliefs about medicines, enhancing self-efficacy, and relieving depression.
Practice Implications:
The value of integrated interventions targeting the drivers and barriers to medication adherence identified in this study should be further explored.
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