Investigating the pathways of medication adherence in renal transplant recipients based on the COM-B model: the parallel mediating effects of beliefs and emotion regulation efficacy

Medication adherence among KTRs remains suboptimal. Within the COM-B framework, this study confirms that medication literacy and social support not only directly affect adherence but also exert indirect effects through the dual mediating pathways of medication beliefs and RESE. These findings suggest that clinical interventions should adopt a multidimensional approach, focusing not only on enhancing medication knowledge and support systems but also specifically addressing patients' medication beliefs and emotional self-efficacy. A multi-path synergistic strategy is recommended to optimize intervention effectiveness.