The Mediating Role of Patient Engagement in the Relationship Between Self-Efficacy and Treatment Adherence Among Patients with Multimorbidity

Abstract

Objective: This study aimed to evaluate the presence of a mediating role of patient engagement in the effect of self-efficacy on treatment adherence in patients with multimorbidity.

Methods: In this cross-sectional study, a questionnaire was administered to 414 outpatients with multimorbidity in Kırıkkale province, Türkiye, using a face-to-face interview method between March and July 2025. In addition to questions regarding individual characteristics, the questionnaire included self-efficacy in management of chronic disease), patient engagement, and the Morisky Medication Adherence Scale. Descriptive statistics and PROCESS macro multiple regression analysis were used for data analysis.

Results: Participants perceived their self-efficacy as moderate and their patient engagement and medication adherence levels as good. Self-efficacy increased patient engagement, while patient engagement also increased medication adherence. As the direct effect of self-efficacy on medication adherence was not statistically significant, patient engagement was found to have a full mediating effect.

Conclusion: The importance of patient engagement in managing complex treatment regimens and ensuring treatment adherence, particularly in patients with multimorbidity, was highlighted. Interventions aimed at enhancing self-efficacy in patients with multimorbidity may not be sufficient on their own; strategies to increase patient engagement may be more decisive in terms of treatment adherence. These findings are expected to guide healthcare professionals and policymakers in adopting a patient-centered approach.

Cite this article as: Sönmez S. The mediating role of patient engagement in the relationship between self-efficacy and treatment adherence among patients with multimorbidity. Arch Health Sci Res. 2026, 13, 0330, doi: 10.5152/ArcHealthSciRes.2026.25330.