Determinants of adherence to tuberculosis treatment in Iranian patients: Application of health belief model
Open accessAbstract
INTRODUCTION: Adherence to TB treatment is an important issue for TB control, with key health consequences. Identification of the factors associated with that adherence is also important. The objective of this study was to identify factors associated with adherence to tuberculosis treatment, using the health belief model (HBM). METHODOLOGY: Overall 297 TB patients were recruited to the study using the census method. All patients completed a 40-question survey form anonymously. The questionnaire was developed based on the Health Belief Model. Data collection was carried out through interviews and questionnaires, as well as observing medical records and medical cards to be used in medical performance checklists. RESULTS: The participants comprised 159 men and 138 women with an average age of 56.8 years (range 19-72 years). The results showed that the variables of perceived threat, benefits, barriers, and self-efficacy accounted for 42% of the variance in therapeutic adherence. The strongest predictor of adherence was found to be self-efficacy. CONCLUSION: HBM appears to be a suitable model in predicting therapeutic adherence in TB patients. Our results emphasize the centrality of self-efficacy in treatment adherence, that health educators should consider when developing programs to motivate patients to adhere to treatment.
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In TB care, the Health Belief Model proposes that adherence is shaped by patients' perceived susceptibility to TB-related complications, perceived severity of the disease, perceived benefits of completing treatment, perceived barriers to taking medication regularly, cues to action, and self-efficacy in managing the regimen.
“In the specific case of TB care, the Health Belief Model proposes that adherence is shaped by patients’ perceived susceptibility to TB-related complications, perceived severity of the disease, perceived benefits of completing treatment, perceived barriers to taking medication regularly (such as side effects, stigma, or transport costs), cues to action, and self-efficacy in managing the regimen [29”
From Psychosocial Interventions for Improving Treatment Adherence in Tuberculosis Patients: A Scoping Review of Evidence-Based Approaches. (2026) · cites this paper as [48]
The Results and Discussion link TB treatment adherence to perceived threat (including seriousness and susceptibility), benefits, barriers, and self-efficacy. Our copy does not identify cues to action as an adherence factor, and it does not substantiate transport costs as a specific barrier; its Discussion instead identifies the belief that TB drugs are harmful. Section labels are available, but page numbers are not. (LLM, conf=0.86)
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“Previous studies emphasize the importance of individuals and societies adopting appropriate behaviors to maintain health, avoid diseases, and lead exemplary lifestyles (Araban, Baharzadeh, and Karimy 2017; Azizi, Karimy, and Naseri Salahshour 2018; Moradi-Joo et al. 2019).”
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“…infected, this makes them afraid that people around them such as parents and fetuses will also be infectedThese results are in line with research (Azizi, 2018) which revealed that HBM constructs are able to explain 42% of patient behavior variants, in other words they provide experimental…”
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- Authors
- Azizi, N., Karimy, M., & Salahshour, V. N.
- Affiliations
- Saveh University of Medical Sciences (IR)
- Venue
- The Journal of Infection in Developing Countries
- Published
- 2018-09-30
- Volume
- 12
- Issue
- 09
- Pages
- 706-711
- ISSN
- 1972-2680 (ISSN-L)
- OpenAlex
- W2896738847
- Cited by
- 49
- References
- 31
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 5 · 2023: 7 · 2022: 10 · 2021: 8 · 2020: 4 · 2019: 2
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- The Journal of Infection in Developing Countries (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- tuberculosis, medication adherence, Health Belief Model, self-efficacy, threat perception, perceived benefits, perceived barriers, Iranian patients
- MeSH terms
- Adult, Aged, Antitubercular Agents, Female, Humans, Iran, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Surveys and Questionnaires, Tuberculosis, Tuberculosis, Pulmonary, Linear Models, Self Efficacy, Medication Adherence, Young Adult
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