Annals of Behavioral Medicine

, Volume 23, Issue 2, pp 125–132

Injectable medication for the treatment of multiple sclerosis: The influence of self-efficacy expectations and infection anxiety on adherence and ability to self-inject


    • University of California
  • Arne C. Boudewyn
    • University of California
  • William Likosky
    • Kaiser Permanente Medical Care Group of Northern California
  • Ellen Levine
    • California Pacific Medical Center
  • Donald E. Goodkin
    • University of California

DOI: 10.1207/S15324796ABM2302_7

Cite this article as:
Mohr, D.C., Boudewyn, A.C., Likosky, W. et al. ann. behav. med. (2001) 23: 125. doi:10.1207/S15324796ABM2302_7


The management of many chronic illnesses involves medications that must be injected on a frequent basis. With fewer support resources available, patients are increasingly being obliged to manage injectable medications themselves. Interferon beta-1a (IFNβ-1a), recommended for the treatment of multiple sclerosis (MS), must be injected intramuscularly on a weekly basis. Patients are generally advised and taught to self-inject, if possible. This longitudinal study examined cognitive and affective contributions to the ability to self-inject and adherence to IFNβ-1a over 6 months following initiation of medication. Participants were 101 patients with a relapsing form of MS. Injection self-efficacy expectations, injection anxiety, adherence expectations, method of injection administration, and 6-month adherence to IFNβ-1a were fitted to a path analytic model Pretreatment injection self-efficacy expectations were significantly related to 6-month adherence. This relation was mediated by the patient's ability to self-inject. Patients’experienced level of injection anxiety was related to adherence but not to method of injection.

Copyright information

© The Society of Behavioral Medicine 2001