Analysis of Behavioral Factors on Medications in Gout Patients with Health belief Model Theory

Ika Ratna Hidayati


Objective : To identify behavioral factor associated with medication adherence using the Health Belief Model theory. Methods : This study used a cross sectional approach with accidental sampling technique. The number of samples used 64 people. The instruments were used the adherence to refills medication scale and the Health Belief Model questionnaire which had been tested for validation and reliability on the questionnaire. Data were analysed using multiple linear regression analysis. Conclusions : Each Health Belief Model theory variables which are perceived susceptibility, perceived severity, perceived benefits, and perceived barriers had a significant effect on medication adherence in gout patients (p <0.05) except self-efficacy had no significant effect (p>0.05). The Health Belief Model Theory had coefficient determination (R2) 59.7%. This indicates that the Health Belief Model can predict the behavior of patients who adhere to treatment well.

Keywords : Adherence, Health Belief Model, Gout, Community Health Center, Behavior

Full Text:



Dipiro J, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy Handbook 9th Edition. 9th editio. (Education M-H, ed.). United States: McGraw-Hill Education; 2014.

FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res. 2020;72(6):744-760. doi:10.1002/acr.24180

Kuo CF, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: Prevalence, incidence and risk factors. Nat Rev Rheumatol. 2015;11(11):649-662. doi:10.1038/nrrheum.2015.91

Widyanto WF. Artritis Gout Dan Perkembangannya. Saintika Med. 2017;10(2):145. doi:10.22219/sm.v10i2.4182

Riskesdas K. Hasil Utama Riset Kesehatan Dasar (RISKESDAS). Vol 44. Jakarta; 2018.

Dinas Kesehatan Kota Malang. Laporan Kasus Asam Urat Di Kota Malang Tahun 2019. Malang; 2019.

Li Q, Li X, Wang J, et al. Diagnosis and treatment for hyperuricemia and gout: A systematic review of clinical practice guidelines and consensus statements. BMJ Open. 2019;9(8):1-13. doi:10.1136/bmjopen-2018-026677

Rothschild BM. Gout and Pseudogout. Medscape. Published 2019.

Reach G, Chenuc G, Maigret P, Elias-Billon I, Martinez L, Flipo RM. Implication of character traits in adherence to treatment in people with gout: A reason for considering nonadherence as a syndrome. Patient Prefer Adherence. 2019;13:1913-1926. doi:10.2147/PPA.S227329

Perez-Ruiz F, Desideri G. Improving adherence to gout therapy: An expert review. Ther Clin Risk Manag. 2018;14:793-802. doi:10.2147/TCRM.S162956

Scheepers LEJM, Burden AM, Arts ICW, et al. Medication adherence among gout patients initiated allopurinol: A retrospective cohort study in the Clinical Practice Research Datalink (CPRD). Rheumatol (United Kingdom). 2018;57(9):1641-1650. doi:10.1093/rheumatology/key155

Conner M, Norman P. Health Behavior. In: Comprehensive Clinical Psychology. ; 1998:1-37. doi:10.4324/9781315732947-11

Jeihooni AK, Hidarnia A, Kaveh MH, Hajizadeh E, Askari A. The effect of an educational program based on health belief model on preventing osteoporosis in women. Int J Prev Med. 2015;2015(November). doi:10.4103/2008-7802.170429

Glanz K, Rimer barbara k., Viswanath K. Health Behavior and Health Education : Theory, Research, and Practice. 4th editio. United States of America: John Wiley & Sons, Inc.; 2008.

Li Y, Piranavan P, Sundaresan D, Yood R. Clinical Characteristics of Early‐Onset Gout in Outpatient Setting. ACR Open Rheumatol. 2019;1(7):397-402. doi:10.1002/acr2.11057

Martini N, Bryant L, Karu L Te, et al. Living with gout in New Zealand: An exploratory study into People’s knowledge about the disease and its treatment. J Clin Rheumatol. 2012;18(3):125-129. doi:10.1097/RHU.0b013e31824e1f6f

Zandman-Goddard G, Amital H, Shamrayevsky N, Raz R, Shalev V, Chodick G. Rates of adherence and persistence with allopurinol therapy among gout patients in Israel. Rheumatol (United Kingdom). 2013;52(6):1126-1131. doi:10.1093/rheumatology/kes431

Sheng F, Fang W, Zhang B, Sha Y, Zeng X. Adherence to gout management recommendations of Chinese patients. Med (United States). 2017;96(45):1-6. doi:10.1097/MD.0000000000008532

Spaetgens B, Pustjens T, Scheepers LEJM, Janssens HJEM, van der Linden S, Boonen A. Knowledge, illness perceptions and stated clinical practice behaviour in management of gout: a mixed methods study in general practice. Clin Rheumatol. 2016;35(8):2053-2061. doi:10.1007/s10067-016-3212-2

Singh JA. Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: A qualitative study. Arthritis Res Ther. 2014;16(2):1-13. doi:10.1186/ar4524

Shao C, Wang J, Liu J, Tian F, Li H. Effect of a health belief model-based education program on patients’ belief, physical activity, and serum uric acid: A randomized controlled trial. Patient Prefer Adherence. 2018;12:1239-1245. doi:10.2147/PPA.S166523

Venkatachalam J, Abrahm S, Singh Z, Stalin P, Sathya G. Determinants of patient′s adherence to hypertension medications in a rural population of Kancheepuram District in Tamil Nadu, South India. Indian J Community Med. 2015;40(1):33-37. doi:10.4103/0970-0218.149267

Ayele K, Tesfa B, Abebe L, Tilahun T, Girma E. Self care behavior among patients with diabetes in harari, eastern ethiopia: The health belief model perspective. PLoS One. 2012;7(4). doi:10.1371/journal.pone.0035515

Kamran A, Sadeghieh Ahari S, Biria M, Malepour A HH. Determinants of Patient’s Adherence to Hypertension Medications: Application of Health Belief Model Among Rural Patients. Ann Med Heal Sci Res. 2014;4(6):922-927. doi:doi:10.4103/2141-9248.144914

Harvey JN, Lawson VL. The importance of health belief models in determining self-care behaviour in diabetes. Diabet Med. 2009;26(1):5-13. doi:10.1111/j.1464-5491.2008.02628.x

Shojaei S, Farhadloo R, Aein A, Vahedian M. Effects of the Health Belief Model (HBM)-based educational program on the nutritional knowledge and behaviors of CABG patients. J Tehran Univ Hear Cent. 2016;11(4):181-186.

Chan AHY, Cooper V, Lycett H, Horne R. Practical Barriers to Medication Adherence: What Do Current Self- or Observer-Reported Instruments Assess? Front Pharmacol. 2020;11(May):1-11. doi:10.3389/fphar.2020.00572

Singh JA, Herbey I, Bharat A, et al. Gout Self-Management in African American Veterans: A Qualitative Exploration of Challenges and Solutions From Patients’ Perspectives. Arthritis Care Res. 2017;69(11):1724-1732. doi:10.1002/acr.23202


  • There are currently no refbacks.