Application of the information-motivation-behavioral skills model to improve medication adherence among older adults with type 2 diabetes: findings from a quasi-experimental study in Kermanshah, Iran

Abstract Introduction Medication adherence is crucial for effective blood sugar control in diabetes patients. However, older adults face a higher risk of non-adherence. This study aims to evaluate the effectiveness of a theory-based program designed to enhance medication adherence among older adults...

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Main Authors: Mehdi Mirzaei-Alavijeh, Saba Yarmoradi, Shima Khashij, Farzad Jalilian
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-06000-w
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Summary:Abstract Introduction Medication adherence is crucial for effective blood sugar control in diabetes patients. However, older adults face a higher risk of non-adherence. This study aims to evaluate the effectiveness of a theory-based program designed to enhance medication adherence among older adults with type 2 diabetes. Methods This quasi-experimental study involved 100 elderly individuals with type 2 diabetes in Kermanshah, Iran, in 2024. Participants were randomly assigned to an intervention (50) or control group (50). The intervention group attended six 40-minute sessions over six weeks, based on the Information-Motivation-Behavioral Skills (IMB) model. Data were collected via a questionnaire assessing demographics, IMB model components, and medication adherence. Data were analyzed using SPSS version 16, employing chi-square tests and t-tests for comparisons, moreover, effect sizes were determined using Cohen’s d. Results The intervention group showed significant improvements, especially in “Information,” with a very large effect size of 1.3 and an average change of 3.84 (p < 0.001). In contrast, the control group had minimal changes. Other components like “Attitude” and “Self-efficacy” also had large effect sizes (0.65 and 0.67). However, “Subjective Norms” showed a small effect size (0.11) with no significant changes. Additionally, the intervention group showed a significant improvement in medication adherence (effect size 1.15), increasing scores from 16.92 to 19.76, (p < 0.001) while the control group had minimal changes. Conclusion The program based on the IMB model significantly improved medication adherence among elderly individuals with type 2 diabetes. We also identified the key theoretical methods of behavior change for each determinant of the IMB model and recommend utilizing them in the development of similar future interventions.
ISSN:1471-2318