Adherence to treatment among chronically ill ambulatory patients

Open access


According to Information-Motivation-Behavioural Skills model (IMB), accurate Information, strong Motivation and adequate Behavioural skills are prerequisites of treatment adherence. This model has been verified among chronically ills patients, usually suffering from one particular disorder. No studies report how the model fits data from a more diverse group. The aim of the study was to analyze adherence and its barriers in a group of three hundred patients suffering from various, common chronic disorders. They filled out IMB and Adherence Questionnaire. Information and Motivation correlated moderately (.35). Behavioural Skills was the strongest predictor of adherence (.24). An additional relationship was found: Information and Motivation interacted and the role of either of these dimensions vanished if the indices of the other were high enough. The relationships between IMB dimensions and adherence were confirmed in a varied clinical sample. Behavioural skills must be considered when working with non-adherent patients, as they are the strongest predictor of adherence. Other interventions may be limited to either Information or Motivation only if there is a chance of raising one of them to extreme levels. This may be useful with special cases, when increasing both is problematic.

Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice Hall.

Bandura, A. (1986). Social foundations of thought and action: A socialcognitive theory. Englewood Cliffs, NJ: Prentice-Hall.

Bojanowska A., & Zalewska, A.M. (2015). Lay understanding of happiness and the experience of well-being - are some conceptions of happiness more benefi cial than others? Journal of Happiness Studies, doi:

Dawson, J.F. (2014). Moderation in management research: What, why, when and how. Journal of Business and Psychology, 29, 1-19. doi:

Fisher, J.D., Fisher, W.A., Amico, K.R., & Harman, J.J. (2006). An information- motivation-behavioural skills model of compliance to antiretroviral therapy. Health Psychology, 25(4), 462-473. doi:

Fisher, J.D., Fisher, W.A., Bryan, A.D., & Misovich, S.J. (2002). Information- motivation-behavioural skills model-based HIV risk behaviour change intervention for inner-city high school youth. Health Psychology, 21(2), 177-186. doi:

Fisher, J.D., Fisher, W.A., Williams, S.S., & Malloy, T.E. (1994). Empirical tests of an information-motivation-behavioural skills model of AIDS-preventive behaviour with gay men and heterosexual university students. Health Psychology, 13(3), 238-250. doi:

Goodell, L.S., Pierce, M.B., Amico, K.R., & Ferris, A.M. (2012). Parental Information, Motivation, and Behavioural Skills Correlate with Child Sweetened Beverage Consumption. Journal Of Nutrition Education And Behaviour, 44(3), 240-245.

Hayes, A.F. (2015). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York: Guilford Press.

IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp

Jones, C.J., Smith, H.E., Frew, A.J., Toit, G.D., Mukhopadhyay, S., & Llewellyn, C.D. (2014). Explaining compliance to self-care behaviours amongst adolescents with food allergy: A comparison of the health belief model and the common sense self-regulation model. British Journal Of Health Psychology, 19(1), 65-82. doi:

Junling, G., Jingli, W., Yaocheng, Z., & Jinming, Y. (2013). Validation of an information-motivation-behavioural skills model of self-care among Chinese adults with type 2 diabetes. BMC Public Health, 13(1), 1-6. doi:

Kiene, S.M., Fisher, W.A., Shuper, P.A., Cornman, D.H., Christie, S., MacDonald, S., & Fisher, J.D. (2013). Understanding HIV transmission risk behaviour among HIV-infected South Africans receiving antiretroviral therapy: An Information - Motivation - Behavioural Skills Model analysis. Health Psychology, 32(8), 860-868. doi:

Mayberry, L.S., & Osborn, C.Y. (2014). Empirical Validation of the Information- Motivation-Behavioural Skills Model of Diabetes Medication Compliance: A Framework for Intervention. Diabetes Care, 37(5), 1246-1253. doi:

Misovich, S.J., Martinez, T., Fisher, J.D., Bryan, A., & Catapano, N. (2003). Predicting breast self-examination: A test of the information-motivation- behavioural skills model. Journal Of Applied Social Psychology, 33(4), 775-790. doi:

Morisky, D.E., Green, L.W., Levine, D.M. (1986). Concurrent and predictive validity of a self-reported measure of medication compliance. Med Care 24: 67-74.

OECD: Organisation for Economic Co-operation and Development (2013).Health at a glance 2013: OECD Indicators, OECD Publishing.

Osborn, C.Y., & Eged, L.E. (2010). Validation of an information-motivation- behavioural skills model of diabetes self-care (IMB-DSC). Patient Education And Counseling, 79(1), 49-54. doi:

Phillips, L.A., Leventhal, H., & Leventhal, E.A. (2012). Physicians’ communication of the common-sense self-regulation model results in greater reported compliance than physicians’ use of interpersonal skills. British Journal Of Health Psychology, 17(2), 244-257.doi:

Quine, L., Steadman, L., Thompson, S., & Rutter, D.R. (2012). Compliance to anti-hypertensive medication: Proposing and testing a conceptual model. British Journal Of Health Psychology, 17(1), 202-219. doi:

Rosenstock, I.M., Strecher, V.J., & Becker, M.H. (1988). Social learning theory and the Health Belief Model. Health Education Quarterly, 15(2), 175-183. doi:

van Dulmen, S., Sluijs, E., van Dijk, L., de Ridder, D., Heerdink, R., Bensing, J. (2007). Patient compliance to medical treatment: a review of reviews. BMC Health Serv. Res. 7, 55. doi:

Vrijens, B., De Geest, S., Hughes, D.A., Kardas, P., Demonceau, J., Ruppar,T., et al. (2012). A new taxonomy for describing and defi ning compliance to medications. Brit. J. Clin. Pharmacol. 73, 691-705. doi:

World Health Organization (2003). Compliance to long-term therapies. Geneva: WHO Publications.

Zarani, F., Besharat, M.A., Sadeghian, S., & Sarami, G. (2012). An Information- Motivation-Behavioural Skills (IMB) Model-Based Intervention for CABG Patients. International Journal Of Behavioural Medicine, 19(4), 543-549. doi:

Zhu, C., Cai, Y., Ma, J., Li, N., Zhu, J., He, Y., & Qiao, Y. (2013). Predictors of Intention to Smoke among Junior High School Students in Shanghai, China: An Empirical Test of the Information-Motivation- Behavioural Skills (IMB) Model. Plos ONE, 8(11), 1. doi:

Polish Psychological Bulletin

The Journal of Committee for Psychological Sciences of Polish Academy of Sciences

Journal Information

CiteScore 2016: 0.33

SCImago Journal Rank (SJR) 2016: 0.185
Source Normalized Impact per Paper (SNIP) 2016: 0.258


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 260 215 12
PDF Downloads 118 110 7