Information-Motivation-Behavioral Skills Model Identifies Barriers to Diabetes Medication Adherence

A variety of pills on a table
A variety of pills on a table
Investigators used the Information-Motivation-Behavioral skills model of adherence to examine associations between patient characteristics and barriers to adherence to treatment for type 2 diabetes.

Only 7% of people with diabetes report no barriers to medication adherence, and the most frequently reported barriers are forgetting to take the medication (49%) and thinking that brand-name medications work better than generic (40%), according to a study published in Diabetes Research and Clinical Practice.

The study investigators recruited participants with diabetes from clinics across Tennessee to create a study sample of 237 eligible participants. Using a card-sorting task designed to simply identify common barriers to medication adherence, the researchers determined that the most reported barriers were forgetting doses (49%), believing brand-name medications function better than generic (40%), disappointment when medications do not immediately improve diabetes (37%), and burnout related to taking medications daily (36%).

Of those prescribed insulin, the most frequently reported insulin-related barrier was pain experienced when injecting the medication (32%).

With this study’s findings, clinicians can improve rates of medication adherence by intervening to address common medication adherence barriers. Clinicians can also use this information to initiate conversations to determine individuals’ unique barriers and address these directly.

The investigators conclude, “this may include education about medications and/or changes to the medication regimen in response to adherence barriers (e.g., switching from generic to brand name medication or prescribing a medication that does not have a specific feared side effect). Our results also inform interventions at the group level by detailing which domains should be targeted based on participant characteristics. Finally, including the barriers assessment in intervention trials will support determining if reductions in barriers drive improvements in medication adherence.”

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Nelson LA, Wallston KA, Kripalani S, LeStourgeon LM, Williamson SE, Mayberry LS. Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model [published online June 4, 2018]. Diabetes Res Clin Pract. doi: 10.1016/j.diabres.2018.05.046