Background: Patients’ medication-related concerns and necessity-beliefs predict adherence. Evaluation of the potentially complex interplay of these two dimensions has been limited because of methods that reduce them to a single dimension (difference scores).

Purpose: We use polynomial regression to assess the multidimensional effect of stroke-event survivors’ medication-related concerns and necessity beliefs on their adherence to stroke-prevention medication.

Methods: Survivors (n = 600) rated their concerns, necessity beliefs, and adherence to medication. Confirmatory and exploratory polynomial regression determined the best-fitting multidimensional model.

Results: As posited by the necessity-concerns framework (NCF), the greatest and lowest adherence was reported by those necessity weak concerns and strong concerns/weak Necessity-Beliefs, respectively. However, as could not be assessed using a difference-score model, patients with ambivalent beliefs were less adherent than those exhibiting indifference.

Conclusions: Polynomial regression allows for assessment of the multidimensional nature of the NCF. Clinicians/Researchers should be aware that concerns and necessity dimensions are not polar opposites.

Original languageEnglish
Pages (from-to)7-16
Number of pages10
JournalAnnals of Behavioral Medicine
Issue number1
StatePublished - 1 Aug 2014


  • Bivariate evaluation plane
  • Medication adherence
  • Necessity-Concerns Framework (NCF) and the Beliefs about Medicines Questionnaire (BMQ)
  • Polynomial regression
  • Stroke survivors


Dive into the research topics of 'The Necessity-Concerns Framework: a Multidimensional Theory Benefits from Multidimensional Analysis'. Together they form a unique fingerprint.

Cite this