Skip to main content

Does adherence-related support from physicians and partners predict medication adherence for vasculitis patients?

Journal of Behavioral Medicine volume 35, pages 115–123 (2012)Cite this article

Abstract

Few studies have explored mediators between medication-related support and medication adherence for individuals with rare, systemic autoimmune conditions. Using the Information-Motivation-Behavioral Skills model, we tested whether depressive symptomatology and medication adherence self-efficacy mediated the relationship between adherence support and changes in medication adherence among vasculitis patients, and whether support from physicians and partners differentially affected medication adherence. Vasculitis patients (n = 172) completed baseline and follow-up questionnaires about their medication adherence and perceived adherence support. Bootstrapped mediation analyses tested the effects of physician and partner support on changes in medication adherence. Adherence self-efficacy mediated the relationship between physician support and changes in medication adherence (B = 0.05, SE = 0.03, 95% CI 0.01, 0.13). Neither self-efficacy nor depressive symptomatology mediated the effects of partner support. Although physicians spend little time with patients, they can increase patients’ confidence about taking medications correctly and potentially improve health outcomes by bolstering medication adherence.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  • Amico, K. R., Barta, W., Konkle-Parker, D. J., Fisher, J. D., Cornman, D. H., Shuper, P. A., et al. (2009). The Information-Motivation-Behavioral Skills model of ART adherence in a deep South HIV+ clinic sample. AIDS and Behavior, 13, 66–75.

    PubMed  Article  Google Scholar 

  • Amico, K. R., Toro-Alfonso, J., & Fisher, J. D. (2005). An empirical test of the Information, Motivation and Behavioral Skills model of antiretroviral therapy adherence. AIDS Care, 17, 661–673.

    PubMed  Article  CAS  Google Scholar 

  • Antonucci, T. C., & Akiyama, H. (1987). An examination of sex differences in social support among older men and women. Sex Roles, 17, 737–749.

    Article  Google Scholar 

  • Bastone, E. C., & Kerns, R. D. (1995). Effects of self-efficacy and perceived social support on recovery-related behaviors after coronary artery bypass graft surgery. Annals of Behavioral Medicine, 17, 324–330.

    Article  Google Scholar 

  • Carpenter, D. M., DeVellis, R. F., Hogan, S. L., Fisher, E., DeVellis, B., & Jordan, J. M. (2010). The effect of conflicting medication information and physician support on medication adherence for chronically ill patients. Patient Education and Counseling, 81, 169–176.

    PubMed  Article  Google Scholar 

  • Carpenter, D. M., DeVellis, R. F., Hogan, S. L., Fisher, E. B., DeVellis, B. M., & Jordan, J. M. (2011a). Use and perceived credibility of medication information sources for vasculitis patients: Differences by gender. Journal of Health Communication, 16, 629–642.

    PubMed  Article  Google Scholar 

  • Carpenter, D. M., Kadis, J. A., DeVellis, R. F., Hogan, S. L., & Jordan, J. M. (2011b). The effect of medication-related support on the quality of life of patients with vasculitis in relapse and remission. Journal of Rheumatology, 38, 709–715.

    PubMed  Article  Google Scholar 

  • Dean, A., Kolody, B., & Wood, P. (1990). Effects of social support from various sources on depression in elderly persons. Journal of Health and Social Behavior, 31, 148–161.

    PubMed  Article  CAS  Google Scholar 

  • DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology, 23, 207–218.

    PubMed  Article  Google Scholar 

  • DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment. Archives of Internal Medicine, 160, 2101–2107.

    PubMed  Article  CAS  Google Scholar 

  • Dunkel-Schetter, C. (1984). Social support in cancer: Findings based on patient interviews and their implications. Journal of Social Issues, 40, 77–98.

    Article  Google Scholar 

  • Fauci, A. S., Haynes, B. F., Katz, P., & Wolff, S. M. (1983). Wegener’s granulomatosis: Prospective clinical and therapeutic experience with 85 patients for 21 years. Annals of Internal Medicine, 98, 76–85.

    PubMed  CAS  Google Scholar 

  • Fisher, E. B., Brownson, C. A., O’Toole, M. L., Anwuri, V. V., & Shetty, G. (2007). Perspectives on self-management from the diabetes initiative of the Robert Wood Johnson Foundation. The Diabetes Educator, 33, S216–S224.

    Article  Google Scholar 

  • Fisher, J. D., & Fisher, W. A. (1992). The Information-Motivation Behavioral Skills model. In R. DiClemente, R. Crosby, & M. Kegler (Eds.), Emerging theories in health promotion practice and research (pp. 40–70). San Francisco, CA: Jossey Bass Publishers.

    Google Scholar 

  • Fisher, W. A., Fisher, J. D., & Harman, J. (2009). The Information-Motivation-Behavioral Skills model: A general social psychological approach to understanding and promoting health behavior. In J. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness. Malden, MA: Blackwell Publishing Ltd.

    Google Scholar 

  • Hajj-Ali, R. A., Wilke, W. S., Calabrese, D. O., Hoffman, G. S., Liu, X., Bena, J., et al. (2011). Pilot study to assess the frequency of fibromyalgia, depression, and sleep disorders in patients with granulomatosis with polyangiitis (Wegener’s). Arthritis Care and Research, 6, 827–833.

    Google Scholar 

  • Haynes, R. B., Yao, X., Degani, A., Kripalani, S., Garg, A., & McDonald, H. P. (2006). Interventions for enhancing medication adherence. Cochrane Database Systematic Review, 4, 513–522.

    Google Scholar 

  • Helgeson, V. S., & Cohen, S. (1996). Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychology, 15, 135–148.

    PubMed  Article  CAS  Google Scholar 

  • Hesse, B. W., Nelson, D. E., Kreps, G. L., Croyle, R. T., Arora, N. K., Rimer, B. K., et al. (2005). Trust and sources of health information: The impact of the internet and its implications for health care providers: Findings from the first Health Information National Trends Survey. Archives of Internal Medicine, 165, 2618–2624.

    PubMed  Article  Google Scholar 

  • Holt-Lunstad, J., Birmingham, W., & Jones, B. Q. (2008). Is there something unique about marriage? The relative impact of marital status, relationship quality, and network social support on ambulatory blood pressure and mental health. Annals of Behavioral Medicine, 35, 239–244.

    PubMed  Article  Google Scholar 

  • Jayne, D. R. W. (2002). Conventional treatment and outcome of Wegener’s granulomatosis and microscopic polyangiitis. Cleveland Clinic Journal of Medicine, 69, S110–S115.

    Article  Google Scholar 

  • Jerant, A., DiMatteo, R., Arnsten, J., Moore-Hill, M., & Franks, P. (2008). Self-report adherence measures in chronic illness: Retest reliability and predictive validity. Medical Care, 46, 1134–1139.

    PubMed  Article  Google Scholar 

  • Kalichman, S. C., Rompa, D., DiFonzo, K., Simpson, D., Austin, J., Luke, W., et al. (2001). HIV treatment adherence in women living with HIV/AIDS: Research based on the Information-Motivation-Behavioral Skills model of health behavior. Journal of the Association of Nurses in AIDS Care, 12, 58–67.

    PubMed  Article  CAS  Google Scholar 

  • Kleeberger, C. A., Buechner, J., Palella, F., Detels, R., Riddler, S., Godfrey, R., et al. (2004). Changes in adherence to highly active antiretroviral therapy medications in the Multicenter AIDS Cohort Study. AIDS, 18, 683–688.

    PubMed  Article  Google Scholar 

  • Koutantji, M., Harrold, E., Lane, S. E., Pearce, S., Watts, R. A., & Scott, D. G. I. (2003). Investigation of quality of life, mood, pain, disability, and disease status in primary systemic vasculitis. Arthritis and Rheumatism, 49, 826–837.

    PubMed  Article  Google Scholar 

  • Krousel-Wood, M., Islam, T., Webber, L. S., Re, R., Morisky, D. E., & Muntner, P. (2009). New medication adherence scale versus pharmacy fill rates in hypertensive seniors. American Journal of Managed Care, 15, 59–66.

    PubMed  Google Scholar 

  • Langford, C. A., Klippel, J. H., Balow, J. E., James, S. P., & Sneller, M. C. (1998). Use of cytotoxic agents and cyclosporine in the treatment of autoimmune disease: Part 2: Inflammatory bowel disease, systemic vasculitis, and therapeutic toxicity. Annals of Internal Medicine, 129, 49–58.

    PubMed  CAS  Google Scholar 

  • Lanza, A. F., Cameron, A. E., & Revenson, T. A. (1995). Perceptions of helpful and unhelpful support among married individuals with rheumatic diseases. Psychology & Health, 10, 449–462.

    Article  Google Scholar 

  • Lazo, M., Gange, S. J., Wilson, T. E., Anastos, K., Ostrow, D. G., Witt, M. D., et al. (2007). Patterns and predictors of changes in adherence to highly active antiretroviral therapy: Longitudinal study of men and women. Clinical Infectious Diseases, 45, 1377–1385.

    PubMed  Article  Google Scholar 

  • MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99–128.

    PubMed  Article  Google Scholar 

  • Morisky, D. E., Green, L. W., & Levine, W. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care, 24, 67–74.

    PubMed  Article  CAS  Google Scholar 

  • Murray, M. D., Young, J., Hoke, S., Tu, W., Weiner, M., Morrow, D., et al. (2007). Pharmacist intervention to improve medication adherence in heart failure: A randomized trial. Annals of Internal Medicine, 146, 714–725.

    PubMed  Google Scholar 

  • Nicklett, E. J., & Liang, J. (2010). Diabetes-related support, regimen adherence, and health decline among older adults. Journal of Gerontology: Social Sciences, 65B, 390–399.

    Article  Google Scholar 

  • Nieuwkerk, P. T., & Oort, F. J. (2005). Self-reported adherence to antiretroviral therapy for HIV-1 infection and virologic treatment response: A meta-analysis. Journal of Acquired Immune Deficiency Syndromes, 38, 445–448.

    PubMed  Article  Google Scholar 

  • Parienti, J. J., Massari, V., Descamps, D., Vabret, A., Bouvet, E., & Larouzé, B. (2004). Predictors of virologic failure and resistance in HIV-infected patients treated with nevirapine- or efavirenz-based antiretroviral therapy. Clinical Infectious Diseases, 38, 1311–1316.

    PubMed  Article  CAS  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, 36, 717–731.

    Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.

    PubMed  Article  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  • Remien, R. H., Hirky, A. E., Johnson, M. O., Weinhardt, L. S., Whittier, D., & Le, G. M. (2003). Adherence to medication treatment: A qualitative study of facilitators and barriers among a diverse sample of HIV+ men and women in four U.S. cities. AIDS and Behavior, 7, 61–72.

    PubMed  Article  Google Scholar 

  • Risser, J., Jacobson, T. A., & Kripalani, S. (2007). Development and psychometric evaluation of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) in low-literacy patients with chronic disease. Journal of Nursing Measurement, 15, 203–219.

    PubMed  Article  Google Scholar 

  • Rogers, P. G., & Bullman, W. R. (1995). Prescription medication compliance: A review of the baseline of knowledge. A report of the National Council on Patient Information and Patient Education. Pharmacoepidemiology and Drug Safety, 2, 3–36.

    Google Scholar 

  • Roth, M. T., Esserman, D. A., Ivey, J. L., & Weinberger, M. (2009). Racial disparities in the quality of medication use in older adults: Baseline findings from a longitudinal study. Journal of General Internal Medicine, 25, 228–234.

    PubMed  Article  Google Scholar 

  • Sackett, D. L., & Haynes, R. B. (Eds.). (1976). Compliance with therapeutic regimens. Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  • Simoni, J. M., Frick, P. A., & Huang, J. M. (2006). A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy. Health Psychology, 25, 74–81.

    PubMed  Article  Google Scholar 

  • Simoni, J. M., Frick, P. A., Lockhart, D., & Liebovitz, D. (2002). Mediators of social support and antiretroviral adherence among an indigent population in New York City. AIDS Patient Care and STDs, 16, 431–437.

    PubMed  Article  Google Scholar 

  • Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. In S. Leinhardt (Ed.), Sociological methodology (pp. 290–312). Washington, DC: American Sociological Association.

    Google Scholar 

  • Starace, F., Massa, A., Amico, K. R., & Fisher, J. D. (2006). Adherence to antiretroviral therapy: An empirical test of the Information-Motivation-Behavioral Skills model. Health Psychology, 25, 153–162.

    PubMed  Article  Google Scholar 

  • Strahan, R., & Gerbasi, K. (1972). Short, homogenous version of the Marlowe-Crowne social desirability scale. Journal of Clinical Psychology, 28, 191–193.

    Article  Google Scholar 

  • Uchino, B. N. (2004). Social support and physical health: Understanding the health consequences of relationships. New Haven, CT: Yale University Press.

    Google Scholar 

  • Yates, B. C. (1995). The relationships among social support and short- and long-term recovery outcomes in men with coronary heart disease. Research in Nursing and Health, 18, 193–203.

    PubMed  Article  CAS  Google Scholar 

Download references

Conflict of interest

The authors have no conflict of interest to disclose.

Author information

Affiliations

  1. Department of Health Behavior and Health Education, UNC Gillings School of Global Public Health, CB#7440, Chapel Hill, NC, 27599, USA

    Jessica K. Pepper

  2. Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, CB#7355, Chapel Hill, NC, 27599, USA

    Delesha M. Carpenter

  3. UNC Thurston Arthritis Research Center, University of North Carolina, CB# 7280, Chapel Hill, NC, 27599, USA

    Robert F. DeVellis

Authors
  1. Jessica K. Pepper
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Delesha M. Carpenter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert F. DeVellis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jessica K. Pepper.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 111 kb)

Supplementary material 2 (DOC 106 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Pepper, J.K., Carpenter, D.M. & DeVellis, R.F. Does adherence-related support from physicians and partners predict medication adherence for vasculitis patients?. J Behav Med 35, 115–123 (2012). https://doi.org/10.1007/s10865-012-9405-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-012-9405-5

Keywords

  • Medication adherence
  • Social support
  • Vasculitis
  • Autoimmune conditions
  • Depression
  • Self-efficacy