Can illness beliefs, from the common-sense model, prospectively predict adherence to self-management behaviours? A systematic review and meta-analysis

Abstract

Objective: To determine whether people’s beliefs about their illness, conceptualised by the common sense model (CSM), can prospectively predict adherence to self-management behaviours (including, attendance, medication, diet and exercise) in adults with acute and chronic physical illnesses.

Design and Main Outcome Measures: Electronic databases were searched in September 2014, for papers specifying the use of the ‘CSM’ in relation to ‘self-management’, ‘rehabilitation’ and ‘adherence’ in the context of physical illness. Six hundred abstracts emerged. Data from 52 relevant studies were extracted. Twenty-one studies were meta-analysed, using correlation coefficients in random effects models. The remainder were descriptively synthesised.

Results: The effect sizes for individual illness belief domains and adherence to self-management behaviours ranged from .04 to .13, indicating very weak, predictive relationships. Further analysis revealed that predictive relationships did not differ by the: type of self-management behaviour; acute or chronic illness; or duration of follow-up.

Conclusion: Individual illness belief domains, outlined by the CSM, did not predict adherence to self-management behaviours in adults with physical illnesses. Prospective relationships, controlling for past behaviour, also did not emerge. Other factors, including patients’ treatment beliefs and inter-relationships between individual illness beliefs domains, may have influenced potential associations with adherence to self-management behaviours.

Keywords:

• illness beliefs
• common sense model
• self-regulation theory
• self-management
• adherence
• systematic review

Acknowledgements

This research was undertaken as part of a PhD Studentship awarded to N.Aujla by the University of Nottingham. We are thankful to several authors who provided unpublished data that was used for this meta-analysis: Deidre Lane for the TREAT randomised trial; David French; Helen Goodman; Yvonne Leung; Emma Massey; Lesley Stafford; and Elizabeth Steed.