Academic Journal
Charting the path to better diabetes outcomes: Revealing psychosocial influences on medication adherence through the information-motivation-behavioral skills model among adults with type 2 diabetes.
| Title: | Charting the path to better diabetes outcomes: Revealing psychosocial influences on medication adherence through the information-motivation-behavioral skills model among adults with type 2 diabetes. |
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| Authors: | Yang YM; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan., Chan HY; Department of Industrial Education, National Taiwan Normal University, Taipei City, 106308, Taiwan., Ho YF; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan., Lin HW; School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung City, 404333, Taiwan; Department of Pharmacy, China Medical University Hospital, Taichung City, 404332, Taiwan; Department of Pharmacy System, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois, 60612, USA., Wang CC; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei City, 100229, Taiwan., Wang T; Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, 48109, USA., Huang YM; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei City, 100229, Taiwan. Electronic address: yenming927@ntu.edu.tw. |
| Source: | Research in social & administrative pharmacy : RSAP [Res Social Adm Pharm] 2026 Jan; Vol. 22 (1), pp. 96-106. Date of Electronic Publication: 2025 Aug 23. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: United States NLM ID: 101231974 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1934-8150 (Electronic) Linking ISSN: 15517411 NLM ISO Abbreviation: Res Social Adm Pharm Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier |
| MeSH Terms: | Diabetes Mellitus, Type 2*/drug therapy , Diabetes Mellitus, Type 2*/psychology , Medication Adherence*/psychology , Hypoglycemic Agents*/therapeutic use , Motivation*, Humans ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Aged ; Adult ; Taiwan ; Surveys and Questionnaires ; Health Knowledge, Attitudes, Practice ; Self Efficacy ; Models, Psychological ; Glycemic Control ; Information Motivation Behavioral Skills Model |
| Abstract: | Background: Psychosocial factors like beliefs, distress, and behavioral skills affect medication adherence. The Information-Motivation-Behavioral Skills (IMB) model addresses these through integrated knowledge, motivation, and skills to support adherence. Objective: This study applied the IMB model to identify salient factors associated with medication adherence and glycemic control among adults with type 2 diabetes (T2D), aiming to clarify mechanisms underlying non-adherence. Methods: A cross-sectional survey was conducted from June 2023 to May 2024 at five community pharmacies in Taiwan using convenience sampling. Eligible participants were adults diagnosed with T2D, currently prescribed at least one oral diabetes medication, and able to read Traditional Chinese. Data were collected via a structured questionnaire covering demographics, clinical characteristics, and four IMB-based constructs. Specifically, eHealth literacy represented the information component; medication-related beliefs (i.e., perceived concerns and necessity of medications) reflected the motivation construct; and self-efficacy captured behavioral skills. Medication adherence was assessed in two domains: medication-taking and medication refill behaviors. Path analysis was used to examine relationships among psychosocial variables, adherence behaviors, and glycemic control. Results: A total of 273 participants completed the questionnaire. Higher self-reported medication-taking behavior was significantly associated with better glycemic control (β = 0.198, p < 0.001). This behavior was positively influenced by stronger eHealth literacy (β = 0.177, p = 0.002), fewer medication-related concerns (β = 0.307, p < 0.001), and greater perceived necessity of medications (β = 0.124, p = 0.027), with self-efficacy serving as a key mediator (β = 0.257, p < 0.001). Refill adherence was also linked to improved A1C levels (β = 0.120, p = 0.028), though no psychosocial predictors were identified for this domain. Conclusions: The IMB model offers a useful framework for understanding adherence behaviors in T2D. Self-efficacy emerged as a central influence, mediating the effects of eHealth literacy and beliefs about medicines. (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors have no competing interests to report. |
| Contributed Indexing: | Keywords: Adherence; Diabetes; Information-motivation-behavioral skills model; Literacy; Medication; Self-efficacy; eHealth |
| Substance Nomenclature: | 0 (Hypoglycemic Agents) |
| Entry Date(s): | Date Created: 20250828 Date Completed: 20251119 Latest Revision: 20260324 |
| Update Code: | 20260324 |
| DOI: | 10.1016/j.sapharm.2025.08.010 |
| PMID: | 40877075 |
| Database: | MEDLINE |
| ISSN: | 1934-8150 |
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| DOI: | 10.1016/j.sapharm.2025.08.010 |