Self-Efficacy as a Mediator Between Medication Adherence and Self-Care in Inflammatory Bowel Disease: A Multicenter Cross-Sectional Study.
Piergiorgio Martella, Manuele Cesare, Silvia Cilluffo and 5 others
PMID 42219883WHAT IT FOUND
The largest group of IBD patients had medium adherence, and forgetting medication was the common barrier.
Adherence was linked to routine self-care and confidence, but not to monitoring symptoms or managing flares.
Key findings
01The largest adherence group was medium adherence (48.4%), high adherence was 10.2%, and forgetting medication was the most frequently reported barrier.
02Medication adherence was associated with self-care maintenance and self-efficacy, but not with self-care monitoring or self-care management.
03Self-efficacy accounted for a small part of the association between medication adherence and self-care maintenance.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured associations at one time point, so it cannot show that self-efficacy causes adherence or that adherence causes self-care. The analytical aims were added after data collection and were not pre-specified in the protocol. Medication adherence and self-care maintenance were self-reported and may overlap, so the link could reflect similar questions rather than separate behaviours. The MMAS-8 was designed for daily oral medicines, but many patients were receiving biological therapy, so some items may not fit all treatment schedules. Participants were recruited from outpatient clinics by convenience sampling, so patients not attending or with other conditions may be missing. There was no a priori sample size calculation for these aims. Differences in local protocols, nursing support, and patient education across the nine hospitals could not be fully controlled.
Declared interests
The authors report no funding to disclose and declare no conflicts of interest.
The easy way to misread this
Do not conclude that improving self-efficacy will increase medication adherence or self-care. The study measured associations at one time point, self-efficacy accounted for only a small part of one link, and the aims were not pre-specified.