Theory of planned behavior and adherence in chronic illness: a meta-analysis
Abstract
Social-cognitive models such as the theory of planned behavior have demonstrated efficacy in predicting behavior, but few studies have examined the theory as a predictor of treatment adherence in chronic illness. We tested the efficacy of the theory for predicting adherence to treatment in chronic illness across multiple studies. A database search identified 27 studies, meeting inclusion criteria. Averaged intercorrelations among theory variables were computed corrected for sampling error using random-effects meta-analysis. Path-analysis using the meta-analytically derived correlations was used to test theory hypotheses and effects of moderators. The theory explained 33 and 9 % of the variance in intention and adherence behavior respectively. Theoretically consistent patterns of effects among the attitude, subjective norm, perceived behavioral control, intention and behavior constructs were found with small-to-medium effect sizes. Effect sizes were invariant across behavior and measurement type. Although results support theory predictions, effect sizes were small, particularly for the intention-behavior relationship.
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Studies of adherence to medications in long-term conditions identified high susceptibility, severity of the condition, strong intentions and high self-efficacy as associated with good adherence, while poor lifestyle habits and low perceived behavioural control were associated with poor adherence.
“Studies that investigated adherence to medications in long-term conditions identified factors such as high susceptibility, severity of the condition, strong intentions and high self-efficacy as being associated with good adherence, while poor lifestyle habits and low perceived behavioural control were associated with poor adherence.468,469”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [468]
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2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., Hoes, A. W., Jennings, C. S., Landmesser, U., Pedersen, T. R., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw272 · Cited by 3,162 · see citing works
2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., Hoes, A. W., Jennings, C. S., Landmesser, U., Pedersen, T. R., et al. (2016) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2016.08.018 · Cited by 1,582 · see citing works
Harrison, A., Scott, W., Timmins, L., Graham, C. D., & Harrison, A. M. (2021) · AIDS Care · doi:10.1080/09540121.2020.1771263 · Cited by 12 · see citing works
- Authors
- Rich, A., Brandes, K., Mullan, B., & Hagger, M. S.
- Affiliations
- University of Amsterdam (NL)
- Curtin University (AU)
- Corresponding author
- Rich, Antonia
- Venue
- Journal of Behavioral Medicine
- Published
- 2015-05-21
- Volume
- 38
- Issue
- 4
- Pages
- 673-688
- ISSN
- 0160-7715 (ISSN-L)
- 1573-3521
- OpenAlex
- W619965170
- Semantic Scholar
- 6549640081037c6744e4b16aa49e11a18d4250ec
- Cited by
- 272
- References
- 120
- Citations by year
- 2026: 15 · 2025: 21 · 2024: 14 · 2023: 23 · 2022: 34 · 2021: 22 · 2020: 37 · 2019: 59 · 2018: 19 · 2017: 14 · 2016: 12 · 2015: 1
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- eSpace (Curtin University) (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- theory of planned behavior, medication adherence, chronic disease, intention-behavior relationship, attitudes, subjective norms, perceived behavioral control, social cognitive model, adherence prediction
- MeSH terms
- Attitude, Chronic Disease, Humans, Patient Compliance, Psychological Theory, Intention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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