Can temporal self-regulation theory and its constructs predict medication adherence? A systematic review and meta-analysis

ABSTRACT

The relationships between temporal self-regulation theory (TST) constructs (intention, behavioural prepotency and self-regulatory capacity) and medication adherence should be established before further applying the theory to adherence. Searches of PsychINFO, Medline, EMBASE, CINAHL and Web of Science were conducted in 2019 (updated November 2021). Studies had to be original quantitative research, assessed the relationship between one of the constructs and adherence in one illness, and used an adult population. The risk of bias was assessed using the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Three meta-analyses were conducted using R. Moderation analyses were also conducted. A total of 57 articles (60 studies) with 13,995 participants were included, with 7 studies included in more than one analysis. Results identified significant correlations between intention (r = .369, [95% CI: .25, .48]), behavioural prepotency (r = .332, [95% CI: .18, .48]), self-regulatory capacity (r = .213, [95% CI: .10, .32]) and adherence. There was some evidence of publication bias and no significant moderators. No studies explored the interactions in the theory, so whilst the constructs adequately predict adherence, future research should apply the theory to adherence in a specific illness to assess these relationships. Pre-registered on Prospero: CRD42019141395.

KEYWORDS:

• Medication adherence
• TST
• intention
• habit
• cues
• self-regulation

Acknowledgements

The authors would like to thank Marcus Campbell who assisted in the screening of articles, and the authors of the articles who responded to requests for additional information.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The authors would like to thank the Australian Government for providing support to Caitlin Liddelow through the Stipend Scholarship for Higher Degree by Research students. Additionally, Mark Boyes is supported by the National Health and Medical Research Council, Australia (Investigator Grant 1173043).