Medication Adherence and Psychosocial Factors in Adolescents With Type 1 Diabetes Mellitus

Medication adherence is essential for the effective management of Type 1 diabetes in adolescents. This study investigated the associations between medication adherence and diabetes management self-efficacy, anxiety, depression, psychological resilience, perceived helicopter parenting, and glycosylated hemoglobin (HbA1c) levels.

In the study, Morisky Medication Adherence Scale, Diabetes Management Self-Efficacy Scale in Adolescents with Type 1 Diabetes Mellitus, The Hospital Anxiety and Depression Scale, Child and Youth Resilience Measure and Helicopter Parent Attitude/s Scale were administered to 142 adolescent participants aged 12-18 years with Type 1 diabetes mellitus.

Medication adherence was positively correlated with psychological resilience (r = 0.488; p < 0.001) and negatively correlated with diabetes management self-efficacy total score and anxiety level (r = -0.501; p < 0.001 and r = -0.242; p = 0.004, respectively). In group analysis, it was found that self-efficacy and psychological resilience levels were higher and anxiety and depression levels were significantly lower in the group with high medication adherence. In regression analysis, psychological resilience (B = 0.046; p = 0.007), diabetes management self-efficacy (B = -0.035; p = 0.002) and anxiety (B = -0.085; p = 0.015) were independently associated with medication adherence. Significant negative relationships were found between medication adherence and perceived helicopter parenting sub-dimensions, between medication adherence scores and mother basic trust (r = -0.167; p = 0.048), mother ethics (r = -0.181; p = 0.032), father basic trust (r = -0.194; p = 0.022) and father ethics (r = -0.186; p = 0.028) sub-dimensions.

These findings indicate that diabetes management self-efficacy, psychological resilience, anxiety, depression, and helicopter parenting attitude are associated with adherence to medication. Given the cross-sectional design, longitudinal, multicentre, and multi-informant studies are needed to clarify the temporal direction of these relationships.