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. 2010 Nov;81(2):169-76.
doi: 10.1016/j.pec.2009.11.006. Epub 2009 Dec 30.

The effect of conflicting medication information and physician support on medication adherence for chronically ill patients

Delesha M Carpenter  1 , Robert F DeVellis, Edwin B Fisher, Brenda M DeVellis, Susan L Hogan, Joanne M Jordan
Affiliations

The effect of conflicting medication information and physician support on medication adherence for chronically ill patients

Delesha M Carpenter et al. Patient Educ Couns. 2010 Nov.

Abstract

Objective: This article explores the effect of conflicting information, defined as contradictory information about medication topics from different sources, on medication adherence in a sample of chronically ill patients. We specifically investigate whether conflicting information and physician support directly affect medication adherence or whether the effect is mediated by adherence self-efficacy and outcome expectations for medications.

Methods: Vasculitis patients (n = 228) completed two on-line questionnaires which contained measures of conflicting information, adherence self-efficacy, outcome expectations, physician support, and medication adherence. We conducted a mediation analysis using a bootstrapping approach to generate point estimates and 95% confidence intervals to test the significance of each mediated effect.

Results: A majority of patients (51.3%) received conflicting medication information. Conflicting information had a direct negative effect on medication adherence, which was not mediated by self-efficacy or outcome expectations. Alternatively, self-efficacy mediated the positive effect of physician support on medication adherence.

Conclusion: Patients who encounter conflicting medication information are less adherent to their medications. The presence of a supportive physician may counteract the negative effect of conflicting medication information.

Practice implications: Physicians should initiate conversations about conflicting medication information with their patients. Consensus-based guidelines that address medication discrepancies may also reduce the availability of conflicting information.

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Figures

Figure 1
Figure 1
Predicted relationships among conflicting information, physician support, outcome expectations, adherence self-efficacy, and medication non-adherence
Figure 2
Figure 2
Percentage of patients receiving conflicting information by medication topic
Figure 3
Figure 3
Reduced model for the relationships among conflicting information, physician support, outcome expectations, adherence self-efficacy, and medication non-adherence
See this image and copyright information in PMC

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