© 2005 Diabetes UK. Diabetic Medicine, 23, 265–270 265
DOI: 10.1111/j.1464-5491.2005.01778.x
Background
Intensive control of blood glucose and associated cardiovascu-
lar risk factors offers the possibility of reducing the disease
burden in people with Type 2 diabetes [1–3]. A major problem
in translating this into improved outcomes is non-adherence to
medication. Across a wide range of conditions adherence may
be as low as 50% [4]. In a Tayside study, less than one-third of
patients with diabetes were dispensed their single hypoglycae-
mic drug sufficiently regularly to cover 90% of treatment days
in 1 year [5]. Intensive treatment regimens will not improve
outcomes if prescribed medications are not taken regularly.
Although a number of interventions have a limited impact
on adherence, for example simplified dosage regimens, self
Correspondence to: Dr Andrew Farmer, Department of Primary Health Care,
University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
E-mail: andrew.farmer@dphpc.ox.ac.uk
Abstract
Aims Identifying patients’ beliefs about taking medication can inform interventions
to support medication taking, and their evaluation. We set out to establish the range
of these beliefs, and measure the frequency of commonly held beliefs and their cor-
relation with intention to take medication and self-reported medication adherence.
Methods An exploratory survey among Type 2 diabetic patients aged 40 years or
older, registered in general practice, used a questionnaire measuring a range of plausible
beliefs about taking and intention to take medication developed from interviews
where belief elicitation was guided by the Theory of Planned Behaviour. The Medi-
cation Adherence Report Schedule was used as a self-report adherence measure.
Results Questionnaires were returned by 121 (61.7%) people. The majority
strongly agreed with statements about the benefits of taking medication. Nega-
tive beliefs that taking medication would ‘cause unpleasant side effects’ and
‘lead to weight gain’ were held by 24.1 and 13.9% of people, respectively.
Beliefs about benefit were strongly associated with intention to take medication
regularly. Two beliefs were associated with reduced medication adherence:
‘changes to my daily routine would make it more difficult to take my diabetes
medicines regularly’ (P < 0.001), and ‘if I were to take my diabetes medicines
regularly this would lead to my gaining weight’ (P < 0.05).
Conclusions Use of a theoretical model to elicit and identify common beliefs
about taking medication regularly underscores the importance of exploring
weight-gain concerns and how to keep taking tablets when routines change.
Beliefs associated with intention and taking medication will inform intervention
development, implementation and evaluation in randomized controlled studies.
Diabet. Med. 23, 265 –270 (2006)
Keywords adherence, beliefs, medication compliance, Type 2 diabetes
Abbreviations IQR, interquartile range; MARS, Medication Adherence Report
Scale; MDQ, Medicines for Diabetes Questionnaire; TPB, theory of planned
behaviour
Blackwell Publishing, Ltd. Oxford, UK DME Diabetic Medicine 0742-3071 Blackwell Publishing, 2005 22 Original Article Original article Medication beliefs among people with Type 2 diabetes A. Farmer et al.
Measuring beliefs about taking hypoglycaemic
medication among people with Type 2 diabetes
A. Farmer, A.-L. Kinmonth* and S. Sutton*
Department of Primary Health Care, University of
Oxford, Oxford and *General Practice and Primary
Care Research Unit, University of Cambridge,
Institute of Public Health, Cambridge, UK
Accepted 22 May 2005
Final Acceptance 27 August 2005