Patient Preference and Adherence (Jun 2016)
Development of a new diabetes medication self-efficacy scale and its association with both reported problems in using diabetes medications and self-reported adherence
Abstract
Betsy Sleath,1,2 Delesha M Carpenter,1 Susan J Blalock,1 Scott A Davis,1 Ryan P Hickson,1 Charles Lee,3 Stefanie P Ferreri,4 Jennifer E Scott,5 Lisa B Rodebaugh,6 Doyle M Cummings6,7 1Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, 2Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, 3Polyglot Systems, Inc., Morrisville, 4Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, 5Consortium for Implementation Science, Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, 6Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, 7Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA Background: Although there are several different general diabetes self-efficacy scales, there is a need to develop a self-efficacy scale that providers can use to assess patient’s self-efficacy regarding medication use. The purpose of this study was to: 1) develop a new diabetes medication self-efficacy scale and 2) examine how diabetes medication self-efficacy is associated with patient-reported problems in using diabetes medications and self-reported adherence. Patients and methods: Adult English-speaking patients with type 2 diabetes were recruited from a family medicine clinic and a pharmacy in Eastern North Carolina, USA. The patients were eligible if they reported being nonadherent to their diabetes medicines on a visual analog scale. Multivariable regression was used to examine the relationship between self-efficacy and the number of reported diabetes medication problems and adherence. Results: The diabetes medication self-efficacy scale had strong reliability (Cronbach’s alpha =0.86). Among a sample (N=51) of mostly African-American female patients, diabetes medication problems were common (6.1±3.1) and a greater number of diabetes medications were associated with lower medication adherence (odds ratio: 0.35; 95% confidence interval: 0.13, 0.89). Higher medication self-efficacy was significantly related to medication adherence (odds ratio: 1.17; 95% confidence interval: 1.05, 1.30) and inversely related to the number of self-reported medication problems (β=–0.13; P=0.006). Conclusion: Higher diabetes medication self-efficacy was associated with fewer patient-reported medication problems and better medication adherence. Assessing medication-specific self-efficacy may help to identify medication-related problems that providers can help the patients address, potentially improving adherence and patient outcomes. Keywords: diabetes, adherence, self-efficacy, literacy
