Adherence Medication Promotion Program among Hemodialysis Patients: An Application of Capability, Opportunity, and Motivation-Behavior Model (COM-B)

The increasing incidence of chronic kidney disease around the world highlights the need for more attention and appropriate actions to enhance therapeutic outcomes and improve patients’ quality of life. This study aimed to evaluate the efficacy of a program to promote medication adherence among hemodialysis patients using the Capability, Opportunity, and Motivation-Behavior (COM-B) model.

The present study was a quasi-experimental interventional study conducted on 140 chronic kidney patients referred to the Dialysis ward of Imam Reza Hospital (Kermanshah, Iran) divided into two groups of 70 patients as intervention and control during 2021. The program was developed by conducting a needs assessment based on the COM-B model and evaluating it in two stages, before and three months after the implementation. Data were collected by a questionnaire based on the COM-B model and analyzed using the SPSS software (version 16).

After the implementation of the program, the components of capability and medication adherence behavior had a significantly higher average rank in the intervention group. The effect sizes of the intervention components, including capability, opportunity, motivation, and medication adherence behavior, were calculated to be 0.69, 0.19, 0.23, and 0.43, respectively.

Considering the effect sizes of each component, especially behavior, it seems that the developed program based on the COM-B model has enough efficiency and that the employed model is effective for developing programs to promote medication adherence.