Type D personality, self-efficacy, and medication adherence in patients with heart failure—A mediation analysis

• Medication adherence was worse in Type D patients than in non-Type D patients.
• Type D patients had lower self-efficacy compared with non-Type D patients.
• Self-efficacy mediates the relationship between Type D and medication adherence.
• Interventions to increase medication self-efficacy for Type D patients are needed.

BackgroundType D personality is associated with medication non-adherence. Both Type D personality and non-adherence are predictors of poor outcomes. Self-efficacy, which is modifiable, is also associated with medication adherence.ObjectivesTo determine the relationships among Type D personality, self-efficacy, and medication adherence in 84 heart failure patients.MethodsSelf-efficacy, Type D personality, medication adherence, demographic and clinical data were collected. Hierarchical linear regression was used.ResultsType D patients were more likely to have lower self-efficacy (p = .023) and medication non-adherence (p = .027) than non-Type D patients. Low self-efficacy was associated with medication non-adherence (p < .001). Type D personality didn't predict medication adherence after entering self-efficacy in the model (p = .422), demonstrating mediation.ConclusionsSelf-efficacy mediates the relationship between Type D personality and medication adherence. Developing and applying interventions to enhance self-efficacy may help to sever the link between Type D personality and poor outcomes.