Table 3.

IMAB domains and corresponding facilitators and barriers categorized according to COM-B components

COM-B	Domain	Facilitators	Barriers
Capability	Knowledge	Knowledge of treatment effect Information about necessity Information about alternative medication Information about experiences from others Knowledge of how to administer medication	Knowledge of side effects Knowledge of cost of medication
	Skills	Cognitive abilities Coping strategies Communication skills Fine motor skills	Insufficient cognitive, communicative, or physical skills to understand and/or administer medication
	Memory and Attention	Treatment effect Aids (to remember) Social support Embedded in daily routine	Lack of daily routine Experiencing side effects Forgetting to take medication Change of appearance of medication Impact on lifestyle Lack of treatment effect
	Decision-making process	Self-management (patient decides) Satisfying relationship with health professional (communication and trust)	Lack of involvement of health professional (health professional decides, no shared decision making) Doubting own knowledge Influence of health insurance companies
Opportunity	Environmental context and resources	Logistics (having medication in stock) Access to health professionals	Quality of product (needle) Logistics (medication storage temperature, pharmacy has no stock) Cost of medication Travelling (clearing injectable medications through customs) Change of name or appearance of medication
	Social influences	Health professionals (rheumatologist, pharmacist, nurse, general practitioner): capabilities, trust, and empathy Health insurance company: reimburses medication, provides clear information Family and friends: support adherence, support in choices of medication, instrumental support Colleagues: support, understanding	Lack of support from colleagues (incomprehension, negative reactions)
Motivation	Beliefs about capabilities	Aids (to use, to remember) Self-efficacy Good (overall) health status	Difficulty in adherence because of social and work events Lack of daily routine Worse health status Difficult to inject Experience of side effects Doubting own knowledge with regard to medication (as barrier to adherence)
	Beliefs about consequences	Belief of treatment effect Belief of being able to better participate (social, work)	Experience of (long- and short-term) side effects Belief that medication will be harmful: higher disease activity Lack of belief in efficacy Dependency on medication Less acceptance of (long-term) medication Non-acceptance of diagnosis
	Emotions	Joy Gratitude Hope Confidence	Anxiety Sadness Anger Dependency on medication Irritation Incomprehension Disparity Powerlessness/helplessness Insecurity Feeling overwhelmed Feeling crestfallen Grief Embarrassment Regret Stress Disappointment Desolation Despair Agitation
	Motivation and Goals	Improvement of Quality of Life Treatment effect Social participation (including work) Improvement of life expectancy Better relationship with health professional Maintain autonomy	Worse health status/wellbeing Side effects Comorbidity Complexity of regimen Resistance of need for medication Denial of existence of illness Difficulty administering medication Lack of daily routine
	Goal conflict	Embedded in daily routine Treatment effect leading to active social participation (e.g., work) Instrumental support (aids, information) Social support Method of administration (intravenous or low frequency) Stock (always available)	Experiencing side effects Restrictions due to using medication (no alcohol) Worse well-being (mentally and/or physically) Not able to participate (social, work) Distracted from taking medication Lack of social support