Psychosocial Determinants of Statin Medication Adherence

Abstract

ABSTRACT While the effectiveness and benefits of statin medications have been demonstrated in numerous studies, adherence to statin therapy is still less than optimal. Psychosocial factors are attributed to a variety of health behaviors, but the study of their impact on statin medication adherence is limited. This study aimed to (1) investigate the effect of self-regulatory mechanisms impacting patients’ adherence to statin medications, (2) assess the effect of a regulatory fit intervention on the behavior, and (3) investigate how optimism may play a role in adhering to statin medications. Adults taking a statin medication were recruited from a Midwestern University health system and were randomized into two study groups. Each study group was primed with messages that were framed either as promotion or prevention; another randomization followed into three groups for each. Patients were primed with implementation intentions framed as promotion or prevention and one group served as the control receiving no implementation intentions. The Regulatory Focus and Fit Theories were used to design the intervention. The behavior of statin medication adherence and patient psychosocial factors were assessed via a series of questions delivered in two questionnaires two weeks apart. Conditional indirect processing models were designed to test the relationships between the psychosocial factors and the behavior of statin medication adherence. A total of 326 patients completed both surveys. Patients’ prevention compared to promotion orientation positively and significantly impacted the behavior of statin medication adherence directly and indirectly via behavioral intentions and motivational intensity. At weak patient psychosocial factors, the Fit intervention resulted in higher statin medication adherence levels compared to the non-fit or control groups. Patients’ optimism levels positively impacted the behavior of statin medication adherence by significantly influencing behavioral intentions and motivational intensity, when levels of self-efficacy and outcome expectations were low or moderate. Patient psychosocial factors present an area of opportunity to explain the behavior of medication adherence and design interventions that will motivate patients to successfully engage in medication adherence. Future studies are needed to further investigate the effect of these and other psychosocial factors in a variety of medications and populations.