General Beliefs about Medicines among Pharmacy Clients, Healthcare Students and Professionals. Group Differences and Association with Adherence

Abstract

Background: only about 50% of all medicines are used as the prescriber intended. If medicinesare prescribed in an adequate way, an optimised adherence can decrease mortality andhospitalisation and improve health-related outcomes. Beliefs about medicines have been shown tobe an important factor in adherence. Furthermore, beliefs can also bias the content of patientcommunication, which is central to patient-centred care. Research shows that it has been difficultto optimise adherence with existing knowledge. To increase the knowledge about pharmacyclients and healthcare professionals beliefs about medicines could be a new angle in adherenceresearch.Aims: to examine general beliefs about medicines among Swedish pharmacy clients, healthcarestudents and professionals. A further aim was to analyse the association between general beliefsabout medicines and self-reported adherence in pharmacy clients.Methods: the thesis is based on four quantitative, cross-sectional studies. Participants in thestudies were pharmacy clients, healthcare students, doctors, nurses and pharmacy employees. Thedata collections were done through questionnaires including the general part of Beliefs aboutMedicines Questionnaire (BMQ), Medicine Adherence Report Scale (MARS) and backgroundquestions: sex, age, occupation, education, country of birth and own experience of medicines.Results: differences in general beliefs about medicines were found between pharmacy clients andpractising healthcare professionals. Pharmacy clients believed medicines to be more harmful thanpractising healthcare professionals did. Doctors, pharmacists and dispensing pharmacists hadmore beneficial and less harmful beliefs about medicines compared with nurses. Similar patternswere seen for medical, pharmacy and nursing students. Furthermore, third-year medical andpharmacy students were more positive about medicines than first-year students were in theseeducations. Education, origin and own medicine use were important factors in general beliefsabout medicines. Furthermore, beliefs about medicines as something harmful were associatedwith self-reported non-adherence in pharmacy clients.Conclusions: there were distinct differences in general beliefs about medicines betweenpharmacy clients and healthcare professionals. If these differences are not acknowledged therecould be consequences for patient communication and the interrelationship between doctors,nurses and pharmacy employees. It is also important to increase knowledge about how generalbeliefs about medicines and adherence are associated. The results of this thesis can be used forfuture interventions and research aiming for improved adherence.