Evidence map›Paper›PMID 41324742›Full record

ArticleInternational journal of clinical pharmacy2026

Multilevel determinants of medication adherence among Chinese patients with chronic diseases: an ecological analysis based on the health ecology model.

Linnan Yang, Yaqi Wu, Zixin Gu, Qiran Cao, Zixuan Zhang, Yuan He

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Article in International journal of clinical pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Linnan YangSchool of Public Administration, Hohai University, Nanjing, China.
Yaqi WuSchool of Nursing, Nanjing Medical University, Nanjing, China.
Zixin GuInstitute of Medical Humanities, Nanjing Medical University, Nanjing, China.
Qiran CaoSchool of Education Science, Jiangsu Normal University, Xuzhou, China.
Zixuan ZhangInstitute of Medical Humanities, Nanjing Medical University, Nanjing, China.
Yuan HeSchool of Nursing, Nanjing Medical University, Nanjing, China. heyuan@njmu.edu.cn.

Funding

Jiangsu Pharmaceutical Association JSPA-KY-202402National Natural Science Foundation of China 72174092Qinglan Project of Jiangsu Province of China 2023
6 · The paper itself

Abstract

introductionMedication adherence is essential for the effective management of chronic diseases; however, adherence among patients remains suboptimal in China. Understanding the multidimensional determinants of adherence is critical in designing interventions to improve treatment outcomes. The health ecology model (HEM) provides a comprehensive framework that integrates individual, behavioral, social, and environmental influences on health behaviors.

aimThis study aimed to identify the multilevel determinants of medication adherence among Chinese patients with chronic diseases using an ecological framework based on the HEM and to provide evidence to inform pharmacist- and policy-driven strategies to enhance adherence.

methodData were derived from the 2021 Psychology and Behavior Investigation of Chinese Residents, a nationally representative survey of 1162 adults with chronic diseases. Medication adherence was assessed using the Medication Adherence Rating Scale. Independent variables were categorized into five hierarchical levels according to the HEM: personal traits, behavioral characteristics, interpersonal networks, working and living conditions, and policy environment. Binary logistic regression analyses were performed sequentially to identify factors associated with good medication adherence.

resultsAmong the participants, 23.8% demonstrated good adherence to medication. In the final regression model (AUC = 0.721; Hosmer-Lemeshow p = 0.790; R

conclusionThis nationwide study demonstrated that medication adherence among Chinese patients with chronic diseases is influenced by interconnected personal, psychosocial, and socioeconomic factors. Multifaceted interventions, including pharmacist involvement in adherence monitoring, family-based support, mental health screening, and the expansion of subsidy programs, may improve medication adherence and optimize chronic disease management.

Indexed as

Medication AdherenceAdultAgedChinaChronic DiseaseEast Asian PeopleFemaleHealth BehaviorHumansMaleMiddle AgedMultilevel AnalysisYoung AdultChronic diseasesEcological frameworkHealth ecology model (HEM)Medication adherence

Identifiers

PMID41324742
PMCPMC13176154

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.