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Purpose: The purpose was to identify trajectories of medication taking among patients with diabetes and investigate correlates of these trajectories using the information-motivation-behavioral skills (IMB) model.
Methods: This study employed a descriptive correlational, longitudinal design using convenience sampling. The participants were 96 adults with diabetes from an outpatient diabetes clinic at a university-affiliated hospital. Medication taking was assessed at 3 time points: baseline, 6 months, and 12 months. At baseline, study variables based on the IMB model were measured: medication knowledge (information), motivational readiness and social support (motivation), and medication self-efficacy (behavioral skills). Group-based trajectory modeling was used to identify medication-taking trajectories, and multinomial logistic regression was used to assess factors associated with medication-taking trajectories.
Results: Three distinct medication-taking trajectory groups were identified: "high medication taking," "increasing medication taking," and "low medication taking." Higher medication knowledge was associated with the high and increasing medication-taking trajectory groups. Motivational readiness was associated with the high and increasing medication-taking groups. In contrast, higher medication self-efficacy was associated only with the high medication-taking group, not with the increasing and low medication-taking groups.
Conclusions: The findings suggest that knowledge, motivational readiness, and self-efficacy are essential in IMB model-based intervention strategies across dynamic medication-taking patterns to enhance medication taking. Health care providers can help patients with diabetes improve medication taking by understanding their medication-taking trajectories and their correlates. Strategies that enhance medication self-efficacy are essential for patients in the increasing and low medication-taking groups.
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http://dx.doi.org/10.1177/26350106241293120 | DOI Listing |
PLoS One
August 2025
Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Background: The impact of COVID-19-related changes in diabetes self-management and trajectories of HbA1c throughout COVID-19 is not fully understood. Here, we describe HbA1c trajectories, changes in diabetes self-management and their association before, during and after the COVID-19 pandemic (2019-2022).
Methods: During the spring of 2021, we invited 13,641 outpatients from diabetes clinics in the Region of Southern Denmark to complete a questionnaire regarding changes in diabetes self-management during COVID-19.
Drugs Real World Outcomes
March 2025
Department of Practice, Sciences and Health Outcomes Research, University of Maryland School of Pharmacy, 220 Arch Street, Baltimore, MD, 21201, USA.
Background And Objective: Performing lipid testing after statin initiation is recommended to monitor response. Inadequate response may indicate non-adherence, which is associated with an increased risk of cardiovascular events and increased costs. Group-based trajectory modeling is an approach to establish probabilistic developmental trajectories of adherence, differentiating individuals by their distinct longitudinal medication-taking behaviors.
View Article and Find Full Text PDFSci Diabetes Self Manag Care
February 2025
University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania.
Purpose: The purpose was to identify trajectories of medication taking among patients with diabetes and investigate correlates of these trajectories using the information-motivation-behavioral skills (IMB) model.
Methods: This study employed a descriptive correlational, longitudinal design using convenience sampling. The participants were 96 adults with diabetes from an outpatient diabetes clinic at a university-affiliated hospital.
Am J Manag Care
August 2024
Department of Pharmacy Systems Outcomes and Policy, School of Pharmacy, University of Illinois Chicago, 833 S Wood St, Chicago, IL 60612. Email:
Objectives: Adherence to medications is important for the management of chronic diseases. Although the proportion of days covered (PDC) is a common metric for measuring adherence, it may be insufficient to distinguish relevant differences in medication-taking behavior. Group-based trajectory models (GBTMs) have been used to better represent adherence over time.
View Article and Find Full Text PDFPEC Innov
December 2024
Weill Cornell Medical College, Department of Medicine, New York, NY, USA.
Objective: Health misinformation is common and can lead to harmful behaviors such as medication non-adherence. We assessed the impact of a novel patient educational tool focused on overcoming misconceptions among patients with coronary artery disease (CAD).
Methods: We developed the CAD Roadmap, an educational tool aimed at explaining the disease trajectory and overcoming common disease misconceptions (such as that statin medications are not beneficial).