Effects of Physician Communication and Family Hardiness on Patient Medication Regimen Beliefs and Adherence.

This study aims to develop a model that describes how physician communication and family hardiness affect medication regimen beliefs and adherence for patients on regimens to control diabetes and hyperlipidemia (high cholesterol). Study participants (n=1356) completed self-report questionnaires on health beliefs. Pharmacy refill records from a health plan in the United States provided data on their medication adherence. Structural equation modeling was used to model variable relationships. A mediation analysis demonstrated that physician communication behaviors had a significant impact on the patients' behavioral intention to adhere to their regimen and medication adherence when they were mediated by the patient's medication taking health beliefs related to perceived benefit of the regimen, impact of side effects, and cost of regimen. Conversely, family hardiness had no effect on medication-taking behaviors. To improve patient medication-taking behaviors, physician communication behaviors should be targeted. The study suggests the physician's initial regimen discussion is important to both regimen initiation and long-term adherence, and should emphasize the regimen's benefits and how to avoid common side effects. Also, establishing a follow-up physician-patient relationship can enhance regimen adherence and reduce the likelihood that a patient will stop taking the medication due to cost concerns. The research supports the important role the physician plays in health behavior maintenance. Future research should study the effect physicians have on other recurring health behaviors.