The association of depressive symptoms and medication adherence in asthma patients: The mediation effect of medication beliefs

The significant role of depression in influencing medication beliefs, which are pivotal cognitive factors that strongly influence medication adherence, has been established. Poor adherence to asthma-controlled medication poses an significant barrier to achieving optimal asthma management. To explore the potential mediating effects of medication beliefs on the relationship between depressive symptoms and medication adherence in patients with asthma. Demographic and clinical characteristics, depressive symptoms, medication adherence, and medication beliefs were collected using questionnaires. Structural equation modeling, was utilized to model medication beliefs as mediators in the relationship between depressive symptoms and medication adherence. Bootstrapping was performed to analyze the mediation- and contrast-specific indirect effects of the two medication beliefs. Among the patients who participated in the study, 29.6 % with depressive symptoms were more prone to poor adherence and exhibited skepticism toward asthma medications. Depression had a direct effect (direct effect = −0.275, 95%CI: −0.369 to −0.190) and an indirect effect on adherence mediated by medication beliefs (indirect effect = −0.168, 95%CI: −0.224 to −0.121). The specific mediation effect of concern belief was stronger than that of necessity belief (difference = −0.076, 95%CI: −0.132 to −0.029). Depressive symptoms have a direct impact on medication adherence as well as an indirect effect mediated by beliefs about medication, particularly concerns belief.