Empirical validation of the information-motivation-behavioral skills model of diabetes medication adherence: a framework for intervention.
Empirical validation of the information-motivation-behavioral skills model of diabetes medication adherence: a framework for intervention.
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DOI：
10.2337/dc13-1828
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发表时间：
2014
期刊：
影响因子：
16.2
通讯作者：
Osborn CY
中科院分区：
文献类型：
--
作者：
Mayberry LS;Osborn CY
糖尿病药物的次优依从性是普遍存在的，并与不利的健康结果相关，但目前尚不清楚需要哪些干预内容来有效促进糖尿病患者的药物依从性。在其他疾病背景下，信息-动机-行为技能（IMB）模型有效地解释和促进了药物依从性，因此可能在解释和促进糖尿病药物依从性方面具有实用价值。我们在成人2型糖尿病患者样本中测试了IMB模型的假设。参与者（N = 314）完成了访谈者管理的调查和糖化血红蛋白测试。结构方程模型检验了糖尿病药物依从性相关信息、动机和行为技能对药物依从性的影响以及药物依从性对糖化血红蛋白的影响。IMB因素解释了依从性差异的41%，而依从性解释了A1C差异的9%。正如预测的那样，行为技能对依从性有直接影响（β = 0.59, P < 0.001），并介导了信息（间接影响0.08[0.01-0.15]）和动机（间接影响0.12[0.05-0.20]）对依从性的影响。药物依从性显著预测血糖控制（β = - 0.30; P < 0.001）。胰岛素状态和方案复杂性都与依从性无关，也都没有调节IMB结构和依从性之间的关联。结果支持IMB模型的预测，并确定糖尿病药物依从性的可修改和可干预的决定因素。药物依从性促进干预可能受益于针对患者药物依从性相关信息、动机和行为技能的内容，并评估这些决定因素的变化导致药物依从性行为变化的程度。
Suboptimal adherence to diabetes medications is prevalent and associated with unfavorable health outcomes, but it remains unclear what intervention content is necessary to effectively promote medication adherence in diabetes. In other disease contexts, the Information–Motivation–Behavioral skills (IMB) model has effectively explained and promoted medication adherence and thus may have utility in explaining and promoting adherence to diabetes medications. We tested the IMB model’s hypotheses in a sample of adults with type 2 diabetes. Participants (N = 314) completed an interviewer-administered survey and A1C test. Structural equation models tested the effects of diabetes medication adherence-related information, motivation, and behavioral skills on medication adherence and the effect of medication adherence on A1C. The IMB elements explained 41% of the variance in adherence, and adherence explained 9% of the variance in A1C. As predicted, behavioral skills had a direct effect on adherence (β = 0.59; P < 0.001) and mediated the effects of information (indirect effect 0.08 [0.01–0.15]) and motivation (indirect effect 0.12 [0.05–0.20]) on adherence. Medication adherence significantly predicted glycemic control (β = −0.30; P < 0.001). Neither insulin status nor regimen complexity was associated with adherence, and neither moderated associations between the IMB constructs and adherence. The results support the IMB model’s predictions and identify modifiable and intervenable determinants of diabetes medication adherence. Medication adherence promotion interventions may benefit from content targeting patients’ medication adherence-related information, motivation, and behavioral skills and assessing the degree to which change in these determinants leads to changes in medication adherence behavior.
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影响因子：
--
作者：
Heisler, Michele;Faul, Jessica D.;Weir, David
通讯作者：
Weir, David
影响因子：
4.4
作者：
Amico, K. Rivet;Barta, William;Fisher, William A.
通讯作者：
Fisher, William A.
DOI：
10.1080/09540120500038058
发表时间：
2005-08-01
影响因子：
1.7
作者：
Amico, KR;Toro-Alfonso, J;Fisher, JD
通讯作者：
Fisher, JD
DOI：
10.1016/j.jana.2005.07.001
发表时间：
2005-09-01
影响因子：
2
作者：
Kalichman, SC;Cherry, J;Cain, D
通讯作者：
Cain, D
影响因子：
16.2
作者：
Mayberry LS;Osborn CY
通讯作者：
Osborn CY