Self-efficacy mediates the relationship between depressive symptoms and medication adherence among hypertensive African Americans

Many studies have documented the negative effects of depression on adherence to recommended treatment; however, little is known about the mechanism underlying this relationship. Using the Kenny and Baron analytic framework of mediation, the authors assessed whether self-efficacy mediated the relationship between depression and medication adherence in 167 hypertensive African Americans followed in a primary care practice. Depressive symptoms are associated with poor medication adherence (β =.013, p =.036) and low self-efficacy (β = -.008, p =.023). Self-efficacy is negatively associated with medication adherence at follow-up (β = -.612, p <.001). The relationship between depressive symptoms and medication adherence becomes nonsignificant when controlling for self-efficacy (β =.010, p =.087). Implications for further examination into the mediating role of self-efficacy and the deleterious effect of depression on medication adherence are discussed.