Obedience and motivation as mechanisms for adherence to medication: a study in obese type 2 diabetic patients

Figures & data

Appendix I The questionnaire

Your health in general
1. Physically, how do you feel?
In very good health	In rather good health	In poor health	In very poor health
2. What do you think that your health generally depends on?
You	Other people	Chance
3. Do you think that your health is important?
In no way	A little bit	Rather	A lot
4. Does the opinion of your family count?
In no way	A little bit	Rather	A lot
5. Do you think that following the recommendations of your physician is good for you?
In no way	A little bit	Rather	A lot
6. Do you smoke?
No	Yes	I stopped
7. Generally speaking, what do you give priority to?
To the present	To the future
8. Are you used to fastening your seatbelt when you sit in the rear of a car?
No	Yes
9. Do you weigh yourself on a regular basis?
No	Yes
Your medication (from reference^Citation13)
1. This morning, did you forget to take your medication?
No	Yes
2. Since the last consultation, did you run out of medication?
No	Yes
3. Do you sometimes delay taking your treatment with regard to the usual hour?
No	Yes
4. Do you sometimes omit your treatment because, on some days, you forget?
No	Yes
5. Do you sometimes omit your treatment because, on some days, you have the feeling that it does more harm than good?
No	Yes
6. Do you think that you have too many tablets to take?
No	Yes
Your diabetes
1. What is your last HbA1c level?
_____%	I do not know
2. Are you satisfied with the control of your diabetes?
In no way	A little bit	Rather	Completely
3. Would you like to improve the control of your diabetes?
In no way	A little bit	Rather	A lot
4. Would you be ready to make efforts to improve the control of your diabetes?
In no way	A little bit	Rather	A lot
Your blood pressure
1. What is your blood pressure?
_____mmHg	I do not know
2. Are you satisfied with the control of your blood pressure?
In no way	A little bit	Rather	Completely
3. Would you like to improve the control of your blood pressure?
In no way	A little bit	Enough	A lot
4. Would you be ready to make efforts to improve the control of your blood pressure?
In no way	A little bit	Enough	A lot
Your weight
1. What is your weight?
_____kg	I do not know
2. What is your waist measurement?
_____cm	I do not know
3. Are you satisfied with your weight?
In no way	A little bit	Rather	Completely
4. Are you satisfied with your waist measurement?
In no way	A little bit	Rather	Completely
5. Would you like to improve your weight?
In no way	A little bit	Enough	A lot
6. Would you be ready to make efforts to improve your weight?
In no way	A little bit	Enough	A lot
7. What weight would you like to have?
_____kg	I do not know
8. How many centimeters of waist measurement would you like to lose?
_____cm	I do not know
9. Do you feel hampered in your daily activities because of your weight or your stomach?
In no way	A little bit	Enough	A lot
Your motivation
1. Are you motivated to follow the recommendations of your physician?
a. With regard to the prescribed medication
Not motivated	Little motivated	Motivated enough	Very motivated
b. With regard to the practice of a physical activity
Not motivated	Little motivated	Motivated enough	Very motivated
c. With regard to the dietary advice
Not motivated	Little motivated	Motivated enough	Very motivated
2. What are the main reasons that motivate you to follow the recommendations of your physician (several answers are possible):
Feel at ease in my clothes, feel more attractive, be able to buy clothes that I want, to have more energy, to be more active
Move better, feel better
Better control of my diabetes, my blood pressure, my cholesterol, and my risk factors for heart disease
The chance to live longer
I trust my doctor

Table 1 Questions with significantly different answer distributions between adherers and nonadherers

	Whole population (n = 670)	Adherers (n = 535)	Nonadherers (n = 135)	P	Seatbelt fasteners (n = 448)	Seatbelt nonfasteners (n = 213)	P
1 Seatbelt nonfasteners	32.2	27.5	51.1	<0.001
2 Nonadherers	20.1				14.5	31.5	<0.001
3 Hemoglobin A1c > 7%	58.3	54.3	74.2	<0.001	55	64.8	0.016
4 Ex-smoker/current smoker	25.4	22.8	35.8	0.003	19.8	36.6	<0.001
5 Does not measure weight	48.7	43.3	70.1	<0.001	40.5	65.2	<0.001
6 Not motivated	46.9	40.9	70.4	<0.001	40.6	59.5	<0.001
7 Priority to the future: no	60.6	58.3	70	0.013	58.1	65.6	0.065
8 Not ready to make efforts to improve diabetes	25.6	19.8	48.1	<0.001	20.7	35.5	<0.001
9 Recommendations too strict	18.1	14.4	32.6	<0.001	13.8	26.7	<0.001
10 Not interested in changing lifestyle	8.4	6.4	16.3	<0.001	5.8	13.6	<0.001
11 Not a priority	8.5	6.2	17.8	<0.001	6.3	13.1	0.004
12 No time	19.9	17	31.1	<0.001	16.7	26.2	0.004
13 Your health depends on you: no	21	17.5	35.1	<0.001	17.9	27.3	0.006
14 Your health is very important: no	26.4	23	39.7	<0.001	22.2	34.7	<0.001
15 The opinion of your family is very important: no	64.4	62.2	73.3	0.016	59.9	73.6	<0.001
16 Following medical recommendations is very good: no	27.6	22.2	48.9	<0.001	23.9	35.1	0.002

Note: It presents the percentages of answers in the whole population (left column), the percentages observed in patients classified as adherers and nonadherers, and the percentages of patients who declared that they fastened their seatbelt when they were seated in the rear of a car and those who did not make this declaration.

Figure 1 Multiple correspondence analysis. A1, seatbelt fasteners; B1, seatbelt nonfasteners; A2, adherers; B2, nonadherers; A3, HbA_1c ≤ 7%; B3, HbA_1c > 7%; A4, nonsmoker; B4, ex-smoker/current smoker; A5, follows weight on a regular basis; B5, does not follow weight; A6, motivated; B6, not motivated; A7, priority to the future: yes; B7, priority to the future: no; A8, ready to make efforts to improve diabetes control; B8, not ready to make efforts to improve diabetes control; A9, recommendations are too strict: disagree; B9, recommendations are too strict: agree; A10, not interested in changing lifestyle: disagree; B10, not interested in changing lifestyle: agree; A11, not a priority: disagree; B11, not a priority: agree; A12, have no time: disagree; B12, have no time: agree; A13, your health depends on you: agree; B13, your health depends on you: disagree; A14, your health is very important: agree; B14, your health is very important: disagree; A15, the opinion of your family is very important: agree; B15, the opinion of your family is very important: disagree; A16, following doctor’s recommendations is very good: agree; B16, following doctor’s recommendations is very good: disagree.

BerriganDDoddKTroianoRPKrebs-SmithSMBarbashRBPatterns of health behavior in US adultsPrev Med200336561562312689807

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