Illness Perception, Self-Efficacy, and Medication Adherence in Patients With Coronary Artery Disease: A Path Analysis of Conceptual Model

Abstract

Introduction Illness perception and self-efficacy in patients with coronary artery disease (CAD) may affect medication adherence, which is one of the most important challenges in disease management in this group of patients. Objective The present study aimed to investigate the factors influencing medication adherence in CAD patients, especially the effect of illness perception and self-efficacy. Methods This study was cross-sectional and conducted from April to September 2021. A total of 259 patients with confirmed CAD were selected by convenience sampling method based on inclusion criteria. Illness perception, self-efficacy, and medication adherence were investigated using Brief IPQ, SCSES, and MARS_10 questionnaires, respectively. The data were analyzed using the STATA software (version 14) and the regression path analysis method. Results Patients had moderate illness perception and high self-efficacy, and 61.8 of them adhered to their medication regimen. Greater illness perception, better self-efficacy, and higher education had a positive effect on medication adherence, and increasing age had a negative effect on it. The final path model shows a good fit of the data in the model (χ2: 0.37, df: 274, χ2/df: 0.36, CFI: 1, IFI: 0.95, TLI: 1.07, and RMSEA: 0.00). Conclusion The results of the present study suggest that patients’ illness perception can play an important role in predicting self-efficacy in disease management and the level of medication adherence in patients with CAD. To improve self-efficacy and medication adherence, future intervention studies should focus on the patient's illness perceptions and their improvement.

Levels of adherence to treatment, illness perception and acceptance of illness in patients with coronary artery disease - descriptive and correlational study

“…Coronary artery disease (CAD) remains a significant contributor to global mortality, ranking as the third leading cause of death worldwide and accounting for an estimated 17.8 million annual fatalities [ 1 ]. Specifically in Iran, CAD holds the foremost position as the primary cause of death, attributing to approximately 50% of the annual mortality rate [ 2 ]. This widespread affliction places substantial societal burdens in terms of economic costs, disease burden, and escalated mortality rates [ 3 ].…”

“…Illness perception encompasses the organized beliefs a patient holds regarding their disease, exerting a profound influence on their adaptive responses, health-related decisions, and adherence to lifestyle modifications [ 18 – 20 ]. Acceptance of the illness also holds significance and enables patients to function effectively despite the challenges posed by a chronic disease [ 2 ]. Acceptance of the illness involves adapting to living with the illness without judgment, avoidance, or denial, while maintaining engagement in daily activities [ 17 ].…”