Social and Administrative Pharmacy, College of Pharmacy, Seoul National University, Seoul, Korea.
Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea.
PLoS One. 2019 Jan 7;14(1):e0210169. doi: 10.1371/journal.pone.0210169. eCollection 2019.
Older adults suffering from hypertension form firm medication beliefs through lifetime medication management, which significantly affect their medication adherence and treatment outcomes. Understanding whether the patient-physician communication has the potential to change medication beliefs will help design an effective communication strategy to foster favorable medication beliefs. This study aims to determine whether the patient-physician communication is associated with medication beliefs among older adults with hypertension and controls socio-demographics and clinical characteristics. Further, it examines how the association varies with two different types of medication beliefs (medication overuse and harm) for each domain of communication (informative and interpersonal). A self-administered cross-sectional survey was conducted for members of seven senior centers in a metropolitan area of the United States between August and December of 2013. A total of 211 senior members suffering from hypertension completed the questionnaire, which included the Primary Care Assessment Survey (PCAS) and the Beliefs about Medicines Questionnaire (BMQ). The former had two domains of patient-physician communication-informative and interpersonal-while the latter measured medication harm and overuse beliefs. Interpersonal patient-physician communication significantly explained the medication overuse beliefs (β = -0.28, p < 0.05), whereas neither interpersonal nor informative communication significantly explained the medication harm beliefs. Females (β = 1.29, p < 0.01) and participants with higher education (β = 2.66, p = 0.02) more strongly believed that medications are overprescribed. However, participants with low income more strongly believed that medications are harmful. Patient-physician communication, if it touches upon interpersonal aspects, has the potential to change medication overuse beliefs among older adults with hypertension. Identification of the significant factors which affect medication beliefs, will inform the design of a patient-centric communication program that fosters favorable medication beliefs among geriatric hypertensive patients.
患有高血压的老年人通过终身药物管理形成坚定的药物信念,这会显著影响他们的药物依从性和治疗效果。了解患者-医生的沟通是否有可能改变药物信念,将有助于设计一种有效的沟通策略,以培养有利的药物信念。本研究旨在确定患者-医生的沟通是否与高血压老年患者的药物信念相关,并控制社会人口统计学和临床特征。此外,它还研究了沟通的两个不同领域(信息性和人际性)中,沟通的各个领域(信息性和人际性)与每种沟通领域(信息性和人际性)中的药物信念(药物过度使用和药物危害)之间的关联如何变化。2013 年 8 月至 12 月期间,在美国一个大都市区的七个老年中心的成员中进行了一项自我管理的横断面调查。共有 211 名患有高血压的老年成员完成了问卷调查,其中包括初级保健评估调查(PCAS)和药物信念问卷(BMQ)。前者有两个患者-医生沟通领域-信息性和人际性,而后者则衡量药物危害和过度使用信念。人际患者-医生沟通显著解释了药物过度使用信念(β=-0.28,p<0.05),而人际和信息沟通都没有显著解释药物危害信念。女性(β=1.29,p<0.01)和受过高等教育的参与者(β=2.66,p=0.02)更强烈地认为药物被过度开具。然而,收入较低的参与者更强烈地认为药物是有害的。如果患者-医生的沟通涉及到人际方面,它有可能改变高血压老年患者的药物过度使用信念。确定影响药物信念的重要因素,将为设计以患者为中心的沟通计划提供信息,以培养老年高血压患者有利的药物信念。