The current study sought to investigate the relationship between illness perception and medication adherence in the North Shao Zone. The study found that illness perception was associated with medication adherence (X2 = 4.01; p = 0.045). Previous studies [14, 19–23] support that illness perception is significantly associated with medication adherence. Illness perception affects the treatment adherence of patients by shaping their behavior and actions [24–26].
Even if illness perception has a positive impact on adherence to medication as well as diabetes management and control, early half of the patients in this study (54.7%) reported good illness perception. Focusing on illness perception is an important therapeutic strategy in educational interventions to enhance medication adherence. The patient illness perception domain must be integrated into diabetes care and delivered at all levels of the health system. And also patients with negative illness perceptions may benefit from practical interventions such as psycho-educational and cognitive-behavioral interventions [9].
This study focused on illness perception domains related to medication adherence. Illness perception of the three domains was found to significantly contribute to medication adherence. These were perception of acute/chronic timelines (p = 0.025), perception of consequence (p < 0.0001), and emotional representation (p < 0.0001). Previous studies have found consistent [19, 20] to this study.
In the final model, illness consequence, personal control, and perception of emotional representation were positively associated with medication adherence. Diabetics who were more aware of their disease were more adherence to medication. Patient-perceived illness consequences were more associated with diabetes medication adherence. This finding is in line with previous research findings [22, 27]. This may be because patients who believe diabetes is having a serious negative impact on their lives are more likely to continue taking prescribed medications.
In this current study, patients with a high perception of personal diabetes control were more likely to adhere to their diabetes medications. This finding is consistent with studies conducted in Saudi Arabia [12], Tripoli [20], and Gonabadi Hospital [14]. Perceived personal control has a close concept to a patient's commitment and confidence in their ability to manage their illness and adhere to prescribed medications. People are more aware of their illness and health and feel more responsible to adhere better to treatment adherence. Therefore, patients have a high degree of confidence in their ability to control their illness, which influences their medication adherence.
In this study, a higher perception of emotional representation was associated with a higher likelihood of adherence to diabetes medications, which was similar where a study done in Ghana[27], but different where a study done in Malaysia [13]. This finding suggests that patients who perceive higher emotional representation are associated with higher adherence to treatment. Therefore, we need to understand how patients perceive diabetes, because, without emotional representation, treatment may not be adequately tailored to the patient's needs.
The present study has some limitations, including the possibility that self-reported measures are prone to bias in response and overestimate behavioral performance. As well, participants may recall bias to antidiabetic medication adherence that ends to affect study results. The instrument also requires more attention to correct and reliable data by considering the local context.
The implication of the study
Practicing the illness perception domain as a psycho-educational intervention is the preferred strategy for improving antidiabetic medication adherence. This study suggests that illness perception may play an important role in type II diabetes drug use. This has been demonstrated in previous studies and this study. When discussing diabetic self-management, diabetes care practitioners should take into account patients' illness beliefs using psycho-educational approaches. Furthermore, the results indicate that illness perception may have significant clinical benefits for type II diabetic patients. As a result, enhancing illness perception to increase patient medication adherence is an important therapeutic strategy in educational interventions. Therefore, it is recommended that healthcare providers need to understand the impact of disease perception on patient adherence to implement appropriate strategies to improve adherence. In addition, service providers should pay close attention to patient barriers, thoroughly analyze them, and incorporate them into their daily activities.