The impact of health literacy on beliefs about medication in a Dutch medication-using population

Considering health literacy in communication about medications between nurses and patients with heart failure: A cross sectional observational study

OBJECTIVES

To explore the content, style, and initiation of medication-related discussions between nurses and patients to understand how nurses support patients with heart failure, especially those with inadequate health literacy.

METHODS

A cross-sectional design was conducted to observe medication-related conversations between nurses and patients with heart failure in four Dutch outpatient clinics. Conversations were audio-recorded and analyzed using MEDICODE, focusing on content, communication style (monologue or a dialogue), and initiation of the content themes. Health literacy was assessed using the NVS-D and the SBSQ. Results between health literacy groups were compared with descriptive analyses.

RESULTS

A total of 56 patients and 14 nurses participated in the study. Patients classified by one or both of the instruments as having inadequate health literacy (n = 33; 59 %) were generally older, had lower educational levels, and were more often accompanied by informal caregivers. Key themes discussed in the medication-related conversations included how the medication was identified ('medication designation), its dosage and instruction, main effects, side effects, attitude or emotions and other ('various') themes. The 'medication designation' theme was significantly more frequently discussed in the group with adequate health literacy, whereas 'attitude or emotions' and 'various themes' were more commonly discussed among those with inadequate health literacy. Most conversations were nurse-initiated and tended to be monologues, with nurses mainly serving as information providers.

CONCLUSIONS

Nurses primarily initiated and dominated medication-related discussions with a focus on factual aspects of medication, while patients initiated more discussions about their concerns regarding medication. While there was overlap in the topics discussed, notable differences emerged between patients with adequate and inadequate health literacy.

PRACTICE IMPLICATIONS

Improving communication strategies, such as structuring conversations and adopting dialogic approaches may improve patients' engagement and understanding of medication use, leading to more effective management of their condition, particularly benefiting patients with lower health literacy.

A Quantitative Study Exploring and Comparing Key Factors in Medication Management in the Irish Healthcare Setting

BACKGROUND

Shared decision-making in the context of medication management has been shown to be contingent on information-seeking behaviours such as patient knowledge, self-efficacy and engagement.

OBJECTIVE

The aim of this study was to: (i) compare differences in perceptions of patients' knowledge, capabilities and engagement across healthcare professionals (HCPs) and patients and family caregivers and (ii) investigate associations between these factors and patients' medication beliefs using a cross-sectional survey study of patients, family caregivers and community and hospital HCPs in Ireland.

METHODS

Two cross-sectional surveys measuring key factors in medication management were distributed to patients and family caregivers taking three or more medicines and HCPs involved in medicines management. χ2 tests were used to investigate differences between HCPs and patients and family caregivers. Multivariable linear regression with adjustment for the socio-demographic covariates was used to examine key factors in medication management and beliefs about medicine (BMQ-General) in patients and family caregivers.

RESULTS

Overall, 636 responses were received; patients and family caregivers (N = 134, 21%), community (N = 313, 49%) and hospital HCPs (N = 189, 30%). A higher proportion of patients and family caregivers self-reported as 'knowledgeable' about medications (N = 76; 56.7%) than community (N = 75, 24%) and hospital HCPs (N = 44, 23.3%) (p < 0.01). The majority of patients and family caregivers were 'fairly/very confident' they could maintain an accurate medication list without assistance (N = 78; 58.2%), compared to the majority of the community (N = 213, 68.1%) and hospital HCPs (N = 114, 60.3%) who were 'not at all/somewhat confident' (p < 0.01.) These patients and family caregivers also had significantly lower overall beliefs in medication harm (β = -1.23, 95% CI: -2.34, -0.13). Patient and family caregivers who asked HCPs about their medication frequently (> 7 times per year) had higher overall beliefs in medication overuse (β = 1.88, 95% CI: 0.06, 3.69) and medication harm (β = 2.65, 95% CI: 1.10, 4.20), compared to those who never asked.

CONCLUSION

There was divergence between HCPs and patients and family caregivers in their assessments of patients' medication knowledge and capabilities. Engagement between HCPs and patients around medication should be purposeful rather than frequent, to alleviate fears about overuse and harm.

PATIENT OR PUBLIC CONTRIBUTION

The patient and family caregiver survey was developed in partnership with members of the Patient and Public Involvement (PPI) group. Feedback was provided by the group to increase accessibility of survey and maximise distribution. In addition, the survey was piloted among members of the public involved in medication management.

Relationship Between Medication Literacy and Beliefs Among Persons with Type 2 Diabetes Mellitus in Guangdong, China

Purpose

To establish the relationship between medication literacy and medication beliefs among persons with type 2 diabetes mellitus (T2DM).

Patients and methods

A cross-sectional survey of 246 patients with T2DM was conducted between April and November 2022 at a tertiary hospital in Dongguan City, Guangdong Province, China. Subsequently, these patients were administered the General Information Questionnaire, the Chinese version of Medication Literacy Assessment Scale, and the Chinese version of Beliefs about Medicines Questionnaire-Specific via survey.

Results

The medication literacy score of patients with T2DM was 7.82±3.007, and the medication beliefs score was 2.26±4.011. The Pearson correlation analysis revealed a statistically significant but weakly positive correlation (r = 0.271, P < 0.001) between medication literacy and beliefs among patients diagnosed with T2DM. However, there was no significant correlation found between medication literacy and necessity (r = -0.021, P > 0.05), while a lowly negative correlation was observed between medication literacy and concerns (r = -0.307, P < 0.001). Moreover, the multiple linear regression analysis indicated that medication literacy, age, education level, and duration of medication usage were all significant factors influencing patients' medication beliefs (all P < 0.05). Together, these variables accounted for 15.3% of the total variance observed in the regression equation.

Conclusion

The study found a positive correlation between medication literacy and beliefs, and a negative correlation between medication literacy and concerns. These results indicate that enhancing medication literacy can improve medication adherence among individuals with T2DM by reducing concerns and strengthening medication beliefs.

Impact of Pharmacophobia and Pharmacophilia on Perception of Medication Use and Self-Medication Behaviors in Saudi Arabia

Objectives

Pharmacophilia and pharmacophobia have positive and negative effects on treatment outcomes. There exist lacune of information on these phenomena in middle east countries. Therefore the current study aimed to determine the pattern and predictors of Pharmacophilia and pharmacophobia in Saudi Arabia. The study further explored the impact of these phenomena on the perception of medication use and self-medication behaviours.

Experimental design

An online questionnaire-based cross-sectional study was conducted during March-May 2021. Saudi residents aged 15 years or older were eligible for this study. Individuals' attitude towards medication was assessed using the Drug attitude inventory classification questionnaire, and the general belief of medication was assessed using the Beliefs about Medicine Questionnaire.

Observation

One-fifth (n = 101; 20%) and two-third (n = 338; 65%) participants were categorized as pharmacophobic and pharmacophilic, respectively. The mean BMQ score was not statistically significant between the pharmacophobic and pharmacophilic groups (mean difference = 0.314; p-value = 0.176). Males were more likely pharmacophilic than females [AOR: 0.34 (95% CI 0.17-0.69)]. Both groups showed nearly a similar pattern of self-medication behaviours.

Conclusion

There exist a good number of pharmacophobic and pharmacophilic among the Saudi population. A detailed understanding of the attitudes towards treatment among these groups is essential for enhancing treatment outcomes.

Drug-related problems and satisfaction among patients receiving pharmacist-led consultations at the initiation of cardiovascular drugs

BACKGROUND

Drug-related problems (DRPs) lead to substantial morbidity and mortality and increase healthcare costs. Several interventions have been developed to reduce DRPs and improve the outcome of drug therapy.

OBJECTIVE

To investigate DRPs identified through a pharmacist-led intervention and to assess patient satisfaction with the intervention.

METHODS

Patients received two pharmacist consultations 1-2 weeks and 3-5 weeks after collecting a new cardiovascular medicine. Information about patient characteristics, beliefs about medicines (BMQ), DRPs, and patient evaluations were collected using questionnaires.

RESULTS

Pharmacists identified DRPs among 52.4% and 43.1% of the 633 patients at consultation 1 and 2, respectively. Of the DRPs reported in consultation 1, 43.7% were solved at consultation 2. Among patients with side effects, patients who received advice on managing these in consultation 1 where more likely to have solved problems at consultation 2 (61.2% vs. 42.6%, p = 0.008). Female gender, high BMQ concern and the number of new medicines were associated with DRPs. Patients were highly satisfied with the intervention. Predictors of satisfaction were female gender, older age, higher BMQ necessity, face-to-face consultations, longer duration of consultation 1, and solved problems in consultation 2.

CONCLUSIONS

The results indicate that the pharmacist-led follow-up intervention can aid early identification and solving of DRPs in patients prescribed new cardiovascular drugs. Knowledge of factors associated with DRPs and patients' satisfaction may allow further improvement of the intervention.