Regimen Adherence: A Problematic Construct in Diabetes Research

Glasgow, Russell E.; Wilson, Willetta; McCaul, Kevin D.

doi:10.2337/diacare.8.3.300

Cited by 74 publications

(28 citation statements)

References 4 publications

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“…In the present study emphasis was given in measuring intentional or rational poor adherence relative to what patients perceived their doctors' treatment recommendations to be. It could be argued that self-efficacy beliefs may be more predictive of diabetes self-care behaviours (Glasgow, Wilson and McCaul, 1985), a term which emphasises patients' initiative in responding to challenging and constantly changing environmental and biological conditions rather than of intentional non adherencekreatment indiscretions to a "prescribed" regimen. Furthermore, the self report measure of adherence developed for the study is open to criticisms of bias, inaccuracy and questionable reliability inherent in self report measures (Johnson, 1992; Kurtz, 1990; McNabb, 1997).…”

Section: Discussionmentioning

confidence: 99%

“…Self-report adherence scale. Much controversy surrounds the assessment of adherence in general and in diabetes in particular (Glasgow, 1985;Gordis, 1979;McNabb, 1996). It has widely been recognised that the conceptualisation and measurement of adherence to diabetic regimens presents unique problems that pertain to the features of diabetic regimen (absence of a known standard and explicit prescription, different regimen components, independence of treatment components).…”

Section: Methodsmentioning

confidence: 98%

See 1 more Smart Citation

Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus

Griva¹,

Myers²,

Newman

2000

Psychology & Health

181

154

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The study examined the role of illness perceptions and self-efficacy in diabetic regimen adherence and metabolic control among young patients with Insulin Dependent Diabetes Mellitus (IDDM). Sixty-four outpatients with Insulin Dependent Diabetes completed measures of illness perceptions, generalised and diabetes specific selfefficacy and a self-report measure of adherence. Metabolic control (HbAlc) was also assessed. Control, identity and consequences components of illness perceptions were significantly correlated with self-efficacy expectancies. Control beliefs were consistently associated with self-reported adherence across all treatment aspects and accounted for 39% of the predicted variance in total adherence. The associations of the other psychological predictors examined, varied depending on the regimen area. Multiple regression analysis showed that 30.8% of the variance in HbAlc assays was explained by patients' diabetes specific self-efficacy, consequences and identity. Our findings suggest that patients' beliefs are useful predictors of physiological and behavioural outcomes in diabetes self-management and should thus be the focus of routine clinical assessments and future interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 98%

Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus

Griva¹,

Myers²,

Newman

2000

Psychology & Health

181

154

View full text Add to dashboard Cite

show abstract

“…Both adherence to individual regimen prescriptions (involving comparison between a regimen prescription and level of self-care behavior) and absolute levels of self-care behaviors were examined (see ref. 23 for further discussion of the distinction between these terms). Within each regimen area except medication taking, composite level and adherence scores were formed by converting all component measures to standard (Z) scores and then averaging scores on the individual measures described above.…”

Section: Methodsmentioning

confidence: 98%

Social Environment and Regimen Adherence Among Type II Diabetic Patients

Glasgow

Toobert²

1988

Diabetes Care

Self Cite

234

167

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We investigated the reliability and predictive validity of several measures of the social environment using a sample of 127 adults with type II (non-insulin-dependent) diabetes. Of particular interest was a revised scale of family support for performing diabetes self-care behaviors. Across four different aspects of the diabetes regimen, it was consistently found that regimen-specific measures of family support differentiated subjects who were low, medium, or high on adherence better than global family-support scores. Social-environment measures were generally successful in predicting a subject's level of regimen adherence after accounting for variance attributable to demographic factors. The family-support measures were the strongest and most consistent predictors of adherence, but measures of stress and medical-care satisfaction and the interaction between stress and the other social-environment measures also often improved the prediction of a subject's adherence status. These results support the usefulness of measures of the social environment specific to diabetes, and research to investigate other aspects of the social context of regimen adherence is recommended.

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“…We believe noncompliance to be the most important hurdle in the way of achieving good glycemic control. The problem in any study of the factors that interfere with or improve adherence is the difficulty of assessing adherence behavior itself (18). Verbal self-reports (19), clinician ratings (20), and home observations (21) have shown limited value in the measurement of adherence for reasons of patient denial and physician bias.…”

Section: MM Belmonte and Associatesmentioning

confidence: 99%

Impact of SMBG on Control of Diabetes as Measured by HbA1: 3-yr Survey of a Juvenile IDDM Clinic

Belmonte

Schiffrin²,

Dufresne³

et al. 1988

Diabetes Care

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Three hundred twelve diabetic children and adolescents were seen in our diabetic clinic and instructed to test their capillary blood glucose (CBG) twice daily and to use an algorithm to adjust their short-acting insulin. Of this group, 219 youngsters had a full 3-yr period of observation. At each clinic visit, blood was obtained for fasting blood glucose and HbA1 and, once a year, cholesterol and triglycerides were also measured. Patient and parent accuracy in measuring CBG was found to be adequate. The changes over time in HbA1 were nondifferential across age and sex, and there was no difference in the level of HbA1 between age and sex groups, the number of tests reported to have been done by the patients, the number of injections of insulin per day, or the serum cholesterol. There was a significant relationship between the HbA1 and the fasting blood glucose (P less than .001) measured by the laboratory as well as with the serum triglyceride (P less than .01). The failure to improve diabetic control, despite measures that would have been expected to do so, was believed to relate more to a lack of compliance than to a flaw in the therapeutic approach. It was interesting to note that the adolescent patients in the study were in no worse control than the younger children in the group. Although better technical skills are available today to manage diabetes, the psychosocial approach to patient motivation requires improvement.

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Regimen Adherence: A Problematic Construct in Diabetes Research

Cited by 74 publications

References 4 publications

Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus

Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus

Social Environment and Regimen Adherence Among Type II Diabetic Patients

Impact of SMBG on Control of Diabetes as Measured by HbA1: 3-yr Survey of a Juvenile IDDM Clinic

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