Examining Risk Perception and its Influence on Treatment Adherence in Those with Type II Diabetes Mellitus

University of Minnesota Ph.D. dissertation. June 2015. Major: Social and Administrative Pharmacy. Advisor: Timothy Stratton. 1 computer file (PDF); vii, 117 pages.Examining Risk Perception and its Influence on Treatment Adherence in Those with Type II Diabetes Mellitus Reid C. Smith Background: Type 2 diabetes mellitus (T2DM), has quickly become a national epidemic. Adherence to therapies is critical in attempting to ward off complications associated with uncontrolled diabetes. Adherence to therapies remains weak even with advancements in treatment options. Predictors for nonadherence have been studied for several decades. Prescription medication risk perception has been measured and compared between people who completely abstain from medications to treat previously-diagnosed conditions and those who decide to treat using medications. Additionally, perceived risk of disease and of routine risks encountered throughout life have been related to self-care adherence in patients with T2DM. The relationship between risk perception and self-care adherence is an area needing study. Aim: The purpose of this study was to examine the relationship between perception of risk and treatment adherence in adults who have T2DM. Method: A random sample of 381 subjects being treated for T2DM completed a comprehensive Internet-based survey. Along with demographic characteristics the questionnaire contained several scales related to harm and benefit perception, perceived threat of diabetes, self-efficacy, and adherence to diabetes-related self-care treatments. Results: Significant differences were found in perceived risk of oral hypoglycemics between respondents using oral drugs for T2DM vs. those who were not. Likewise, significant differences in risk perception of oral hypoglycemics were observed between men and women. Adherence to self-care treatments was variable, with over one in three respondents having poor medication adherence, and the average number of days exercised in the week leading up to survey completion was less than three days. Adherence to some self-care treatments appears to be significantly related to risk perception. Conclusion: Individuals with T2DM perceive medications for diabetes and its related comorbidities to be of high benefit and low harm. Adherence to exercise, diet, and medication recommendations was relatively low. Results indicate a potential link between risk perceptions and adherence to diabetes-related self-care treatments. Gaining insight into how persons with T2DM perceive the harms and benefits of diabetes-related self-care treatments in relation to risks and benefits of other medical and nonmedical products and activities may help with other areas of diabetes treatment adherence research