Multilevel Ecological and COM-B Determinants of Medication Adherence in Adults With Diabetes
Multilevel Ecological Determinants of Medication Adherence Among Diabetes Patients: A Health Ecology-COM-B Framework Analysis
University of Malaya
220 participants
Dec 15, 2025
OBSERVATIONAL
Conditions
Summary
This observational study aims to understand why some adults with diabetes find it difficult to take their medicines as prescribed. Medication adherence is essential for controlling blood sugar levels and preventing complications, yet many patients face challenges that go beyond personal motivation. The study will examine multiple factors that may influence medication-taking behavior, including patients' understanding of their medicines, beliefs about treatment, family and social support, communication with healthcare providers, and practical issues such as medicine cost, availability, and distance to care. These factors will be analyzed using a structured behavioral framework to better understand how capability, opportunity, and motivation contribute to adherence. By identifying the most important barriers and supports across different levels, this research aims to provide evidence that can guide patient-centered care strategies and improve medication adherence in diabetes management.
Eligibility
Inclusion Criteria5
- Adults aged 18 years or older
- Diagnosed with at least one chronic disease (e.g., diabetes mellitus, hypertension, cardiovascular disease, chronic respiratory disease, chronic kidney disease) for a minimum duration of six months
- Prescribed long-term medication therapy
- Able to understand and respond to the study questionnaire
- Willing to provide written informed consent
Exclusion Criteria4
- Patients with acute medical conditions requiring immediate care
- Individuals with severe cognitive impairment or psychiatric illness that would preclude reliable participation
- Patients who are terminally ill
- Patients unwilling to participate or provide consent
Interventions
Assessment of contextual and behavioral determinants associated with medication adherence among adults with diabetes receiving routine clinical care. Determinants include individual-level factors (medication literacy, beliefs about medicines), interpersonal factors (family involvement, social support), healthcare interaction factors (communication quality, regimen complexity), and structural/access-related factors (availability, affordability, distance). These exposures are measured through validated questionnaires and prescription review during a single outpatient encounter. No intervention is assigned as part of the study.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07420634