Evidence map›Paper›PMID 29879495›Full record

ArticleDiabetes research and clinical practice2018

Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model.

Lyndsay A Nelson, Kenneth A Wallston, Sunil Kripalani, Lauren M LeStourgeon, Sarah E Williamson, Lindsay S Mayberry

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes research and clinical practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 62 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05008211 nacompletednot on this mapstarted 2021, after this paper: background citation

Effectiveness of an Information-Motivation-Behavioral Skills Model-based Intervention on Adherence to Domiciliary Non-invasive Ventilation of Patients With Chronic Hypercapnic Respiratory Failure: A Randomized Controlled Study

TypeinterventionalSponsorThe University of Hong KongRan2021 to 2025Enrolled124ConditionsHypercapnic Respiratory Failure, Noninvasive VentilationArmsInformation-Motivation-Behavioral skills (IMB) model-based intervention, Control - usual care
NCT05923632 narecruitingnot on this mapstarted 2024, after this paper: background citation

The Effect Of Model-Based Dıgıtal Game On Metabolıc Control, Self-Effıcıency And Qualıty Of Lıfe In Chıldren Wıth Type 1 Dıabetes

TypeinterventionalSponsorAbant Izzet Baysal UniversityRan2024 to 2025Enrolled58ConditionsType 1 Diabetes, Children, OnlyArmsDijital Game and Health Education
3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Smart Healthcare-Enabled Information-Motivation-Behavioral Skills Model for Stroke Multimorbidity Rehabilitation: A Transitional Care Study.Medical science monitor : international medical journal of experimental and clinical research · 2026
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  8. Effect of informationZhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2022
    Trial
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  12. Review
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  19. [Influencing factors of responsive caregiving among infant mothers in Weifang City].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2025
    Article
  20. Article

2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lyndsay A NelsonDepartment of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
Kenneth A WallstonSchool of Nursing, Vanderbilt University, Nashville, TN, USA; Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA.
Sunil KripalaniDepartment of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN, USA.
Lauren M LeStourgeonDepartment of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
Sarah E WilliamsonDepartment of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
Lindsay S MayberryDepartment of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: lindsay.mayberry@vanderbilt.edu.

Funding

Vanderbilt Center for Diabetes Translation ResearchP30DK092986 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI OSBORN, CHANDRA Y. · 2011 to 2020
$6.7M
Improving Medication Adherence among Underserved Patients with Type 2 DiabetesR01DK100694 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI MAYBERRY, LINDSAY S. · 2014 to 2018
$3.3M
Targeting Family Behaviors to Improve Diabetes Management among Adults with Type 2 DiabetesK01DK106306 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI MAYBERRY, LINDSAY S. · 2015 to 2018
$568k
NIDDK NIH HHS K01 DK106306NIDDK NIH HHS P30 DK092986NIDDK NIH HHS R01 DK100694
6 · The paper itself

Abstract

aimsMedication nonadherence is a prevalent and costly problem among patients with type 2 diabetes. Applications of theory can inform and improve adherence promotion interventions. We used a new assessment based on the Information-Motivation-Behavioral skills (IMB) model of adherence to assess patient-reported barriers and test the theoretical model.

methodsParticipants (N = 237) completed a card sorting task to identify barriers to adherence, a survey, and a hemoglobin A1c (HbA1c) test. We identified the most commonly reported adherence barriers and examined associations between patient characteristics and barriers mapped onto each of the IMB constructs. We used structural equation modeling to test the IMB model and determine if barriers as reported on this measure predict patients' self-reported diabetes medication adherence and, in turn, HbA1c levels.

resultsThe most frequently reported barriers were forgetting doses, thinking brand name medicine works better than generic medicine, not seeing immediate benefit, and feeling burned out with taking diabetes medicine. Younger age and lower health literacy were associated with higher barrier scores for all IMB model constructs. Information and social motivation barriers affected adherence via behavioral skills barriers (indirect effects -0.19, CI [-0.33, -0.09] and -0.24, CI [-0.37, -0.14], respectively). The IMB barrier constructs explained 44% of the variance in diabetes medication adherence which, in turn, was significantly associated with and explained 8% of the variance in HbA1c (both p < .001).

conclusionsResults suggest this assessment task can identify patient-specific barriers to diabetes medication adherence. Interventions targeting patient-specific barriers using this assessment could improve adherence and HbA1c.

Indexed as

MotivationAdultAgedDiabetes Mellitus, Type 2FemaleHealthcare DisparitiesHumansMaleMedication AdherenceMiddle AgedSurveys and QuestionnairesBehavioral changeDisparities researchGlycemic controlHealth disparitiesIMB modelMedication adherenceType 2 diabetes

Identifiers

PMID29879495
PMCPMC6083841

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.