# Theory of Planned Behaviour Constructs as Predictors of Antiplatelet Medication Adherence Following Percutaneous Coronary Intervention: A Cross-Sectional Study in Saudi Arabia

## TL;DR

This study shows how psychological factors predict whether Saudi patients stick to their heart medication after a cardiac procedure.

## Contribution

It identifies behavioral intention, perceived control, and social norms as key predictors of medication adherence in this specific population.

## Key findings

- Behavioral intention was the strongest predictor of antiplatelet medication adherence.
- Perceived behavioral control and subjective norms also significantly predicted adherence.
- The TPB constructs explained 18.7% of the variance in adherence beyond demographic and clinical factors.

## Abstract

Background: Theoretical frameworks are essential for understanding and predicting medication adherence behaviours. The Theory of Planned Behaviour (TPB) posits that behavioural intentions, shaped by attitudes, subjective norms, and perceived behavioural control, are the proximal determinants of behaviour. This cross-sectional study examined associations between TPB constructs and antiplatelet medication adherence among Saudi patients following percutaneous coronary intervention (PCI). Methods: A cross-sectional survey was conducted among 236 Saudi adults post-PCI at two tertiary cardiac centres in Riyadh. TPB constructs (attitude, subjective norms, perceived behavioural control, intention) were assessed using a validated questionnaire. Adherence was measured via the Morisky Medication Adherence Scale-8 (MMAS-8). Hierarchical multiple regression examined associations between TPB constructs and adherence, controlling for demographic and clinical variables. Results: The results demonstrated significant associations with adherence. In the final regression model, intention (β = 0.273, p < 0.001), perceived behavioural control (β = 0.189, p = 0.007), and subjective norms (β = 0.142, p = 0.038) were significantly associated with adherence. Attitude was not significantly associated (β = 0.087, p = 0.194). The TPB constructs explained an additional 18.7% of variance in adherence beyond demographic and clinical factors. Conclusions: The TPB provides a useful framework for understanding antiplatelet adherence patterns in Saudi post-PCI patients. These findings suggest that interventions addressing behavioural intentions, perceived control over medication-taking, and normative influences from significant others may potentially enhance adherence outcomes. Theory-informed nurse-led interventions incorporating strategies such as implementation intentions and family involvement are recommended.