The mediating role of trust in physician and self-efficacy in understanding medication adherence in severe asthma

Abstract

ObjectiveTo investigate the relationships between beliefs about medication, trust in physician, self-efficacy, and medication adherence in severe asthma patients. MethodsA sample of 117 patients with a diagnosis of Severe Asthma on Step 4 or 5 of GINA assessment of control treatment ladder completed a one-time survey, including the shortened Medication Adherence Report Scale (MARS-5), Beliefs about Medicines Questionnaire (BMQ), Trust in Physician Scale (TIPS), and Self-Efficacy in Taking Medication (SEAMS). ResultsOur study found that medication adherence was associated with trust in physician (p = 0.033); factor one of beliefs about medication - Necessity of taking medication (BMQ1-Necessity: p = 0.025); and two factors of self-efficacy in taking medication (SEAMS1-Difficulty: p = 0.001; SEAMS2-Uncertain: p = 0.005). Furthermore, two factors of self-efficacy and trust in physician together significantly mediated the relationship between beliefs about medication and medication adherence in a serial multiple mediator model. ConclusionsBeliefs about medication are fundamental in affecting asthma patients’ trust in physician and self-efficacy, which in turn impact medication adherence. Clinical implicationsInterventions being developed to improve medication adherence may benefit from emphasizing on asthma patients' concerns about overuse and harm of medication. In addition, education program targeting to improve provider-patient relationship could help with patients’ confidence in taking medication.