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comorbidity, medication adherence, perceptions, self-efficacy, type 2 diabetes



  1. Kim, Hyejin PhD, APRN
  2. Sereika, Susan M. PhD
  3. Lingler, Jennifer H. PhD, CRNP, FAAN
  4. Albert, Steven M. PhD
  5. Bender, Catherine M. PhD, RN, FAAN


Background: Illness perceptions, patients' beliefs about their health condition, may affect medication adherence as well as self-efficacy for managing the condition in type 2 diabetes (T2DM).


Objectives: The aims of this study were to investigate the associations between illness perceptions, self-efficacy, and self-reported medication adherence among persons (>=50 years of age) with T2DM and explore whether the number of comorbid conditions moderates these associations.


Methods: This secondary analysis of cross-sectional data used baseline data from persons with T2DM. Self-administered questionnaires, including the Brief Illness Perception Questionnaire, Self-efficacy for Managing Chronic Disease, and the 4-item Morisky-Green-Levine Medication Adherence Scale, were used. We performed hierarchical multiple linear regression analyses.


Results: Participants (N = 146) were 57.5% female, 67.1% white, and on average 64 years old. Six dimensions of illness perceptions (ie, consequences, personal control, treatment control, identity, concerns, and emotional representations) were associated with self-efficacy for managing T2DM. Five dimensions (ie, timeline, personal control, treatment control, coherence, and emotional representations) were significant predictors of self-reported medication adherence. Whereas the number of comorbid conditions was significantly associated with self-efficacy for managing T2DM in all models (P values < .001), the number of comorbid conditions was not associated with self-reported medication adherence.


Conclusions: This study suggests that illness perceptions and comorbid conditions may play a critical role in either self-efficacy or self-reported medication adherence in persons (>=50 years of age) with T2DM. Future research should incorporate an individual's illness perceptions and comorbid conditions into the development of interventions that may improve both self-efficacy and medication adherence in T2DM.