{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T19:36:08Z","timestamp":1784316968170,"version":"3.55.0"},"reference-count":59,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>This review aimed to synthesize factors associated with medication nonadherence among people with type 2 diabetes (PwT2D), using the Capability, Opportunity, Motivation and Behaviour (COM\u2010B) model as the a priori model.<\/jats:p>\n                  <jats:p>Studies published between January 2014 and April 2024 were searched on five databases. Studies were included if they recruited PwT2D aged &gt;18\u2009years, investigated factors associated with adherence to oral and\/or nonoral medications for diabetes, used qualitative research methods, were conducted in a community setting, were in English language and had accessible full\u2010text articles. Best fit framework synthesis was undertaken, which led to the development of a hypothesized COM\u2010B variant model specific to medication nonadherence among PwT2D. Study quality was assessed using published criteria to evaluate whether the study was adequately reported.<\/jats:p>\n                  <jats:p>Twenty\u2010two studies were included. Factors were mapped onto the COM\u2010B model: physical capability (e.g., difficulty injecting insulin independently), psychological capability (e.g., understanding about diabetes), physical opportunity (e.g., cost of medication), social opportunity (e.g., quality of communication and relationship with healthcare providers), automatic motivation (e.g., habit formation) and reflective motivation (e.g., perceived necessity and effectiveness of medications). Reflective motivation had the most themes, while physical capability only had one theme. Personality was a theme that could not be mapped onto the model. Interactions between some COM\u2010B components (e.g., capability and motivation) were observed.<\/jats:p>\n                  <jats:p>This theoretically grounded synthesis may facilitate future intervention development by formulating a programme theory and identifying behaviour change techniques to address the identified factors.<\/jats:p>","DOI":"10.1002\/bcp.70059","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T05:17:15Z","timestamp":1743743835000},"page":"1675-1691","source":"Crossref","is-referenced-by-count":6,"title":["Best fit framework synthesis of qualitative studies on factors associated with medication nonadherence in people with type 2 diabetes using the COM\u2010B model"],"prefix":"10.1002","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3054-9822","authenticated-orcid":false,"given":"Vivien","family":"Teo","sequence":"first","affiliation":[{"name":"Institute of Pharmaceutical Sciences, King's College London  London UK"},{"name":"Department of Pharmacy National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6786-0166","authenticated-orcid":false,"given":"John","family":"Weinman","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Sciences, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8440-0313","authenticated-orcid":false,"given":"Kai Zhen","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"International Diabetes Federation.IDF Diabetes Atlas 10th edition. 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