case_images: PMC3411184_01
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case_images: Theoretical model: determinants of patient adherence. Adapted from "Which patient-related factors determine self-perceived patient adherence to prescribed dyspepsia medication?" by Fransen et al.. Copyright 2009 by G. A. J. Fransen. Reprinted with permission.
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case_images: PMC3411184_02_fpsyg-03-00267-g001.jpg
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case_images: Theory of Planned Behavior, that further incorporates self-efficacy and perceived barriers into the model to account for factors that may or may not lie within the patient's locus of control (Becker,; Ajzen,; Ryan,). More robust models also recognize additional and complementary causes of medication non-adherence at various levels of analysis, including the patient-provider relationship, systemic barriers such as lack of access and financial resources, and the broader social-economic and cultural context that may impact the perception of medication efficacy and side-effects. An example of such a comprehensive schema that combines the theoretical models mentioned above is provided by Fransen and others (Figure 1). The model summarizes the multiple potential determinants of medication non-adherence and how they inform health beliefs and perceptions of self-efficacy and social norms, to culminate in the intentional behavior of medication taking (Fransen et al.,).