Perceptions about diabetes, medication beliefs, and medication adherence among persons with diabetes

The objectives for this study were to determine whether Caucasian and African American patients with Type 2 diabetes differed in their illness representations, medication beliefs, or medication adherence and to ascertain whether illness representations and medication beliefs mediated any association between race and medication adherence. Analysis of variance was conducted to assess differences in race, illness representations, medication beliefs and medication across race. Regression with bootstrapping was conducted to determine whether illness representations or medication beliefs mediated any association between race and medication adherence while adjusting for covariates including respondent age, time since diabetes diagnosis, social support, total number medications taken for diabetes and total number of medications taken for all conditions including diabetes. Data were collected at the outpatient pharmacy of a primary care clinic affiliated with a hospital in Indianapolis, IN. Study participants were sought from patients waiting to see pharmacists. Study inclusion criteria were being 18 years or older, diagnosed with Type 2 diabetes at least 6 months prior to the time of the survey, and taking oral anti-diabetic medication. Exclusion criteria were use of insulin or not being able to read and write in English. The usable response rate for this study was 56 percent. No differences in medication adherence were observed between Caucasian and African American diabetes patients. With regard to illness representations, Caucasian patients perceived more consequences from diabetes and believed that their illness would last longer as compared to African American patients. African American patients perceived more harm from medications in general and perceived more overuse of medications by prescribers than Caucasian patients. Caucasian patients, agreed more than African American patients about the specific necessity of taking medications for diabetes. Emotional effect of illness and perceived illness threat mediated the association between race and medication adherence. Assessment of perceptions of illness and beliefs about medications can help pharmacists or other healthcare professionals in providing patient-specific counseling related to their medications which may be useful in addressing the problem of poor medication adherence