General beliefs about medicines among doctors and nurses in out-patient care: a cross-sectional study

Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study

BACKGROUND

Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might contribute to inequality by prescribing preventative medication for CVD to themselves in a biased manner.

AIM

To determine whether primary medications for preventing CVD were prescribed inequitably between physicians and non-physicians.

DESIGN AND SETTING

This retrospective study retrieved registry data on prescribed medications for all physicians in Sweden aged 45-74 years, during 2013, and for reference non-physician individuals, matched by sex, age, residence, and level of education. The outcome was any medication for preventing CVD, received at least once during 2013.

METHOD

Age and the sex-specific prevalence of myocardial infarction (MI) among physicians and non-physicians were used as a proxy for the need for medication. Thereafter, to limit the analysis to preventative medication, we excluded individuals that were diagnosed with CVD or diabetes. To analyse differences in medication usage between physicians and matched non-physicians, we estimated odds ratios (ORs) with conditional logistic regression and adjusted for need and household income.

RESULTS

MI prevalences were 5.7% for men and 2.3% for women, among physicians, and 5.4% for men and 1.8% for women, among non-physicians. We included 25,105 physicians and 44,366 non-physicians. The OR for physicians receiving any CVD preventative medication, compared to non-physicians, was 1.65 (95% confidence interval 1.59-1.72).

CONCLUSION

We found an inequity in prescribed preventative CVD medications, which favoured physicians over non-physicians.

Association between healthcare practitioners' beliefs about statins and patients' beliefs and adherence

AIMS

Adherence to statins ranges from 32% to 79%. Patients' beliefs about medication are associated with adherence. There is lack of insight into the possible association between beliefs of healthcare practitioners (HCPs) about statins and patients' beliefs and adherence. This study aims to examine whether HCPs' beliefs about statins are associated with patients' beliefs and adherence about/to statins.

METHODS

Cross-sectional study in 48 pharmacies and affiliated physicians' practices between 3 September 2014 and 20 March 2015. HCPs' (prescribers and pharmacy staff) and patients' beliefs about statins were assessed with the Beliefs about Medicine Questionnaire (BMQ) specific. Adherence to statins was assessed with the MARS-5 questionnaire. Multilevel regression analysis was performed to assess the association between HCPs' beliefs and patients' beliefs and adherence.

RESULTS

1504 patients (mean age 66.8 [s.d. ± 9.9] years, 46.5% female) and 734 HCPs (209 physicians, 118 pharmacists and 366 pharmacy technicians) participated in this study. Patients have higher BMQ necessity (16.9 [s.d. ± 4.3]) and BMQ concern (12.3 [s.d. ± 3.9]) scores than HCPs (15.0 [s.d. ± 3.0] and 11.5 [s.d. ± 2.9], P < 0.001). No associations were found between any of the HCPs' BMQ and patients' BMQ scores and adherence to statins. Patients' BMQ necessity, concern and necessity-concerns (NC)-differential scores were associated with patients' adherence (MARS-5) scores. B (95% CI) coefficients were 0.057 (0.035-0.079), -0.040 (-0.064 to -0.016) and.061 (0.043-0.079).

CONCLUSIONS

Patients have stronger beliefs about medication compared to HCPs. No associations were found between HCPs' BMQ scores on the one hand and patients' BMQ scores and adherence to statins on the other hand.

Are Health Care Professionals' Implicit and Explicit Attitudes Toward Conventional Disease-Modifying Antirheumatic Drugs Associated With Those of Their Patients?

OBJECTIVE

It is generally unknown how the attitudes and beliefs of health care professionals (HCPs) might affect the attitudes, beliefs, and medication-taking behavior of patients with rheumatoid arthritis (RA). This study aims 1) to examine the attitudes, health-related associations (both implicit and explicit), and beliefs of HCPs about conventional disease-modifying antirheumatic drugs, and 2) to assess whether these attitudes, health-related associations, and beliefs of HCPs are associated with those of their patients, with their patients' medication-taking behavior, and disease activity.

METHODS

HCPs were recruited from 2 centers that specialized in rheumatology across The Netherlands, and patient recruitment followed. In this observational study, implicit outcomes were measured with single-category implicit association tests, whereas explicit outcomes were measured with a bipolar evaluative adjective scale and the Beliefs About Medicines Questionnaire-Specific. Spearman's rank correlations were used to describe correlations between implicit and explicit measures of the attitudes of HCPs. Multilevel, mixed-effects linear models were used to examine the association of HCP-related characteristics, including the implicit and explicit outcomes of HCPs, with those of their patients, their medication-taking behaviors, and disease activity.

RESULTS

Of the 1,659 initially invited patients, 254 patients with RA (mean age 62.8 years, mean disease duration 11.8 years, and 68.1% of the patients were female) who were treated by 26 different HCPs agreed to participate in this study. The characteristics, attitudes, health-related associations, and beliefs about medicines of HCPs were not significantly associated with those of their patients, nor with their medication-taking behaviors or disease activity scores.

CONCLUSION

This study demonstrated that the attitudes, health-related associations (as measured both implicitly and explicitly), and beliefs of HCPs were not significantly associated with the attitudes, beliefs, medication-taking behavior, and disease activity of patients with RA.

Medication adherence teaching activity for first year pharmacy students in a Canadian university: Description and evaluation

BACKGROUND AND PURPOSE

Medication non-adherence is a significant health problem in Canada and pharmacists are ideally positioned to help patients adhere to their regimens. There is an urgent need for pharmacy schools to ensure graduates receive training in this area. In this paper, we describe a medication taking simulation activity for first year pharmacy students using a multi-method approach to evaluation.

EDUCATIONAL ACTIVITY AND SETTING

Students were provided with placebo capsules and instructed to take one capsule twice per day for two weeks, complete the Beliefs About Medications Questionnaire (BMQ) before the activity, and provide a pill count and reflection on their experiences afterwards. Quantitative analysis involved calculation of percent adherence from pill counts and establishing beliefs about medications from BMQ scores. Perceptions of the teaching activity were determined using qualitative inductive content analysis of a sub-set of student reflections.

FINDINGS

All 224 students participated and complete pill count and BMQ data was obtained from 190 students (85%). Applying a cut-off of 80% to categorize adherence status, 51.8% of students were adherent. BMQ analyses indicated collective student uncertainty in three BMQ sub-scales (specific-necessity, specific-concern, and general-overuse) and a significant difference between adherent and non-adherent students in the specific-necessity sub-scale. Qualitative analyses of a set of student reflections resulted in two major themes: (1) developing empathy and (2) learning about adherence.

SUMMARY

This activity provided opportunities for students to experience the challenges involved in medication-taking from the patient's perspective and to realize the pharmacist's role to facilitate medication adherence.

Nurses’ Knowledge and Treatment Beliefs: Use of Complementary and Alternative Medicine for Pain Management

Purpose: To examine the relationship between nurses’ knowledge, attitudes, and beliefs about medicines, in general, and complementary and alternative medicine (CAM) and identify the predictors of referrals for pain management. Method: This descriptive, correlational study utilized an online survey to collect data from direct care nurses at a large medical center in southeastern United States. The online survey consisted of the Complementary and Alternative Medicines and Beliefs Inventory (CAMBI), the Beliefs about Medicine Questionnaire, and four open-ended questions. Referral data were obtained from the Information Management Department at this medical center. Results: Among the 218 nurses who completed the survey (15.12%), majority (85%) supported CAM use, but only 32% reported utilizing CAM therapies with patients. Medical surgical, emergency department, and perioperative nurses scored higher on their CAMBI total score and were more likely to refer for CAM therapies when compared with intensive care unit nurses. Conclusions: Beliefs about CAM specifically were not related to referrals for CAM therapies. This study suggests the need for further education on the nurse’s role in CAM usage. Understanding the link between nurses’ knowledge, attitudes, and treatment beliefs and their relationship to CAM usage provides direction for future educational interventions.

Length of time periods in treatment effect descriptions and willingness to initiate preventive therapy: a randomised survey experiment

Background

Common measures used to describe preventive treatment effects today are proportional, i.e. they compare the proportions of events in relative or absolute terms, however they are not easily interpreted from the patient’s perspective and different magnitudes do not seem to clearly discriminate between levels of effect presented to people.

Methods

In this randomised cross-sectional survey experiment, performed in a Swedish population-based sample (n = 1041, response rate 58.6%), the respondents, aged between 40 and 75 years were given information on a hypothetical preventive cardiovascular treatment. Respondents were randomised into groups in which the treatment was described as having the effect of delaying a heart attack for different periods of time (Delay of Event, DoE): 1 month, 6 months or 18 months. Respondents were thereafter asked about their willingness to initiate such therapy, as well as questions about how they valued the proposed therapy.

Results

Longer DoE:s were associated with comparatively greater willingness to initiate treatment. The proportions accepting treatment were 81, 71 and 46% when postponement was 18 months, 6 months and 1 month respectively. In adjusted binary logistic regression models the odds ratio for being willing to take therapy was 4.45 (95% CI 2.72–7.30) for a DoE of 6 months, and 6.08 (95% CI 3.61–10.23) for a DoE of 18 months compared with a DoE of 1 month. Greater belief in the necessity of medical treatment increased the odds of being willing to initiate therapy.

Conclusions

Lay people’s willingness to initiate preventive therapy was sensitive to the magnitude of the effect presented as DoE. The results indicate that DoE is a comprehensible effect measure, of potential value in shared clinical decision-making.

Knowledge, beliefs and communication preferences with regards to the HPV vaccine; the perspective of unvaccinated Greek adolescent girls, young women, and mothers of vaccine-eligible girls

Background: Every year in Europe 60,000 women develop cervical cancer and 30,000 die from the disease. HPV vaccines are currently believed to constitute an important element of cervical cancer control strategy. The introduction of the HPV vaccine constitutes a shift in health policy and health promotion practice. The aim of this study was to investigate knowledge, beliefs and communication preferences of the Greek public with regards to the HPV vaccine.

Methods: Six focus groups (5–8 participants) were conducted with unvaccinated teenage girls, young women and mothers of vaccine-eligible girls, recruited via schools and universities. Pre-focus group questionnaires consisted of: socio-demographic details and a knowledge questionnaire. The discussion guide was based on issues raised by relevant studies such as disease severity and personal risk perception, perceived benefits and barriers to vaccination, etc. Participants were also shown three types of stimuli namely, a leaflet, an expert interview and a documentary containing equivalent information on HPV and the HPV vaccine. Thematic analysis was used for analysis of the qualitative data.

Findings: Findings revealed that participants had low to moderate knowledge levels on HPV and cervical cancer. Beliefs specific to the HPV vaccine as well as general beliefs about medicines and their use in everyday life were prevalent. The vaccination dilemma was exacerbated by the conflicting advice received by health professionals coupled with the difficulties participants experienced in evaluating relevant health information. Participants judged all stimuli according to content and format but the documentary was their preferred health information communication option.

Conclusions: Findings could contribute to the understanding of health decision making with regards to preventive vaccination and help formulate recommendations for health policy adjustments.

Factors associated with medication amounts considered excessive among university students: a questionnaire survey of pharmacy students and those in non-medical schools

Background

Better insight and knowledge on factors associated with perception of medication numbers and amounts would contribute greatly to our current understanding of patient psychological response regarding taking medications, and would allow us to improve drug administration support and adherence. This study explored associations between attitudes toward medication dosage in a questionnaire survey that examined demographic characteristics, the number of tablets and types of prescription medications considered excessive by participants, current medication and supplement use, personal experiences with medications, and perceptions surrounding medications.

Methods

An original anonymous questionnaire was used for this survey. A total of 934 university students completed and returned surveys with no missing data.

Results

Mean values ± standard deviation for excessive thresholds for tablets and types of medications reported by all participants were 4.21 ± 1.63 tablets and 4.00 ± 1.25 medications, respectively. The number of tablets considered excessive was analyzed using a multiple regression model, which accounted for the variance (model-adjusted R² = 0.095, p < 0.001) between statistically significant factors, including personal experience with a major illness, supplement use, aversion to taking medications, gender, university departmental affiliation, and experience with family members or acquaintances who took excessive amounts of medications (|beta| > 0.094, p < 0.01). The number of medications considered excessive was subject to a multiple regression analysis (model-adjusted R² = 0.087 p < 0.01), which revealed statistically significant factors, including personal experience with a major illness, prescription medication use, aversion to taking medications, gender, university departmental affiliation, and experience with family members or acquaintances who took excessive amounts of medications (|beta| > 0.084, p < 0.01).

Conclusions

Individual attitudes toward medication dosage are influenced by individual factors. Thus, patients should be provided with personalized advice when they receive medication instructions.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-017-2431-9) contains supplementary material, which is available to authorized users.

How much elderly people of Isfahan are adherent to their drug therapy regimens?

BACKGROUND

The need for a correct follow-up for medical advices of health givers is the cornerstone for avoiding drug-related complications in especial period of elderly people life. There isn't any data about drug therapy regimens adherence of elderly people of Isfahan. In this study, we aimed to cover this deficit.

MATERIALS AND METHODS

In this cross-sectional study which was carried out in Isfahan (Iran) in 2013 senior citizens (aged 65 or more) who were taking at least one medication and had no record of residency in nursing homes were included. We used Morisky medication adherence scale (after validation and reliability assessment for using this questionnaire in Persian language) to evaluate the level of adherence in the study population.

RESULTS

A total of 200 elderly participants were fully studied (n = 200, 61% females), and 52% of them had poor medication adherence. 77.5% of participants were suffered from at least four medical illnesses, and 18.5% of them were taking more than eight medications per day. We have not found any significant statistical relationship between vision or hearing loss disorders and the medication adherence of the participants). There was a significant positive relationship between the level of education and medication adherence (P = 0.001), (χ² = 0.29).

CONCLUSION

Low Medication adherence is a common and important drug issue in the elderly in Isfahan. This issue can lead to medical complications and huge cost if it is not addressed appropriately.

Beliefs about inhaled corticosteroids: Comparison of community pharmacists, pharmacy technicians and patients with asthma

OBJECTIVES

To compare pharmacists' and pharmacy technicians' perceptions of patients' beliefs regarding inhaled corticosteroids (ICS) with those of patients and to compare the ICS beliefs of pharmacists and technicians with those of patients with asthma.

METHODS

1269 community pharmacies were approached to fill out an online questionnaire; 1952 patients were sent a questionnaire by post. Beliefs (i.e., necessity and concerns) regarding ICS were measured using (an adapted version of) the Beliefs about Medicines Questionnaire (BMQ-specific). Pharmacists and technicians were instructed to fill out the BMQ for themselves, and to fill it out in the way they thought most of their patients would complete it.

RESULTS

136 pharmacists, 90 pharmacy technicians and 161 patients with asthma completed the questionnaire. Pharmacists and technicians thought patients had more concerns about ICS than patients themselves reported (p < 0.0001). They also thought that patients had stronger beliefs in their personal need for ICS than patients reported (p < 0.01). Pharmacists reported lower levels of concerns than patients (p < 0.05) and both providers attributed a higher level of necessity to ICS than patients did (p < 0.0001).

CONCLUSION

Pharmacists and technicians overestimate the personal need for treatment as well as the concerns patients with asthma have regarding ICS. They also have, to some extent, stronger positive beliefs about ICS than patients. If pharmacists and technicians expect that patients share their positive views about ICS, they might be less likely to elicit and address patients' doubts and concerns about ICS, which might be relevant for effective ICS treatment and subsequent patient outcomes.

Beliefs about medicines are strongly associated with medicine-use patterns among the general population

AIMS

To investigate self-reported beliefs and perceived sensitivity to medicines and their effects in relation to self-reported use of medicines and herbal remedies.

METHODS

A survey sent to 13,931 randomly selected Swedish adults included the Beliefs about Medicines Questionnaire-General (BMQ-General) Questionnaire and the Perceived Sensitivity to Medicines Scale (PSM). The survey also asked about individuals' use of prescribed and over-the-counter (OTC) medicines and herbal remedies in the past month. We examined all associations between scores on the BMQ-General subscales and PSM in relation to the use of medicines and herbal remedies, using analysis of covariance adjusted for potential confounders.

RESULTS

Among 7099 respondents, those using herbal remedies exclusively believed strongly that prescription and OTC medicines are harmful and overprescribed. Respondents using prescription and OTC medicines reported more positive beliefs [coefficient 0.67 (95% CI 0.47-0.87) and 0.70 (95% CI 0.51-0.90)] on the benefits of medicines compared with those using herbal remedies [-0.18 (95% CI -0.57-0.20)]. Perceived sensitivity to medicines was higher among those using herbal remedies only [1.25 (95% CI 0.46-2.03)] compared with those using no medicines (reference 0) or prescription [-0.44 (95% CI -0.84 to -0.05)] or OTC [-0.27 (95% CI -0.66-0.12)] medicines alone.

CONCLUSION

Respondents using prescription and/or OTC medicines reported stronger positive beliefs about the benefits of medicines in general, supporting the hypothesis that beliefs influence medicine use. Therefore, addressing beliefs and concerns about medicines during patient counselling may influence medicine use, particularly regarding unintentional non-adherence.

Patients' views about taking a polypill to manage cardiovascular risk: a qualitative study in primary care

BACKGROUND

A 'polypill' containing a combination of antihypertensives and statins could prevent up to 80% of cardiovascular disease (CVD) events.

AIM

To investigate patients' opinions about the use of a polypill for CVD prevention.

DESIGN AND SETTING

Qualitative study of 17 patients from seven primary care practices in Birmingham, UK.

METHOD

Patients were recruited through purposive sampling to maximise variation of characteristics. Semi-structured interviews were conducted with responders. Results were analysed and reported using a qualitative description approach.

RESULTS

Patients expressed concerns that polypill prescription for primary prevention simply on the basis of age was unnecessary and would lead to side effects, despite recognising potential benefits. For high-risk patients, or for secondary prevention, a polypill was deemed more acceptable, but was still felt to require regular monitoring of blood pressure and cholesterol.

CONCLUSION

Patients were sceptical about the role of a polypill as a 'blanket' approach. If a population strategy offering a polypill to all people over a certain age was to be implemented, it would need to be supported by patient education.

Lost in translation?: Comparing three Scandinavian translations of the Beliefs about Medicines Questionnaire

OBJECTIVE

The "Beliefs about Medicines Questionnaire" (BMQ) assess balance of necessity and concern of medicines. The BMQ has been translated from English to many languages. However, the original meaning of statements, such as "My medicine is a mystery to me", may be lost in translation. The aim of this study is to compare three Scandinavian translations of the BMQ. (1) How reliable are the translations? (2) Are they still valid after translation?

METHODS

Translated Norwegian, Swedish and Danish versions of the BMQ were scrutinized by three native Scandinavian researchers. Linguistic differences and ambiguities in the 5-point Likert scale and the BMQ statements were compared.

RESULTS

In the Scandinavian translations, the Likert scale expanded beyond the original version at one endpoint (Swedish) or both endpoints (Danish). In the BMQ statements, discrepancies ranged from smaller inaccuracies toward completely different meaning. Some dissimilarities reflect different cultural beliefs about medicines.

CONCLUSION

When translating questionnaires, bilingual researchers should scrutinize translations across similar languages to address content validity across different countries and languages.

PRACTICE IMPLICATIONS

Our findings are of relevance to other BMQ translations in non-English countries, as direct comparisons between different translations might not be reliable or valid.

Use, attitudes and knowledge of medications among pregnant women: A Saudi study

OBJECTIVE

Medication use during pregnancy is a major concern for most women. The aim of the present study was to assess medication use, knowledge and beliefs about medications among pregnant women in Saudi Arabia.

METHODS

More than 760 pregnant women, attending the obstetric clinic, filled a semi-structured questionnaire. Data were collected about their sociodemographic background, medication use during pregnancy, medication/pregnancy risk awareness, sources of drug information and beliefs about medications.

RESULTS

Most women had a positive attitude toward medications in general but they believed pregnant women should be more cautious regarding drug-use during pregnancy. A significant association was found between participants' education and occupation, and beliefs about medications. In this context, well educated women and those working in a health-related career demonstrated more correct beliefs about medications. Women with health-related occupations were more knowledgeable about the life saving effect of drugs on unborn children. Women indicated inadequate provision of drug-related information from physician and pharmacist; they rely on medication pamphlet to get such information. The most frequently used drugs were paracetamol and vitamins (13.2%). Most pregnant women (59.2%) were able to identify drugs to-be avoided in pregnancy that agreed roughly with FDA categories with 23 hits out of 32. They indicated that newborn anomalies (6.5%) were not attributed to drug-use during pregnancy.

CONCLUSION

During pregnancy, women were more conservative and skeptic toward medication, health-care professionals should be aware of such attitudes when advising pregnant women to take medication.

Adherence to and beliefs in lipid-lowering medical treatments: a structural equation modeling approach including the necessity-concern framework

OBJECTIVE

This study attempts to identify a structure among patient-related factors that could predict treatment adherence in statin patients, especially with regards to the necessity-concern framework.

METHODS

414 Swedish patients using statins completed a questionnaire about their health, treatment, locus of control, perception of necessity-concern and adherence. The data were handled using a structural equation modeling approach.

RESULTS

Patients that reported high perceptions of necessity to treatment seemed to adhere well, and side effects appear to affect adherence negatively. Disease burden, cardiovascular disease experience and high locus of control seem to have mediating effects on adherence.

CONCLUSION

This study provides support for the hypothesis that health- and treatment-related factors, as well as locus of control factors, are indirectly associated with treatment adherence via their association with mediating factor necessity.

PRACTICE IMPLICATIONS

This study highlights the importance of considering patients' beliefs about medications, disease burden, experience of cardiovascular events and locus of control as these factors are associated with adherence behavior to statin treatment. This study also emphasizes more generally the importance of an approach targeting necessity and concern when communicating with and treating patients with lipid-lowering medication.

Would primary healthcare professionals prescribe a polypill to manage cardiovascular risk? A qualitative interview study

OBJECTIVES

A 'polypill' containing both blood pressure-lowering and cholesterol-lowering drugs could prevent up to 80% of cardiovascular disease events. Since little is known about the attitudes of primary healthcare professionals to use of such a pill for cardiovascular disease prevention, this study aimed to investigate opinions.

DESIGN

Semistructured interviews were conducted with participants. A qualitative description approach was used to analyse and report the results.

SETTING

Participants were recruited from nine primary care practices in Birmingham.

PARTICIPANTS

Sixteen healthcare professionals (11 primary care physicians and 5 practice nurses) were selected through purposive sampling to maximise variation of characteristics.

OUTCOME MEASURES

Outcome measures for this study were: the attitude of healthcare professionals towards the use of a polypill for primary and secondary cardiovascular disease prevention; their views on monitoring the drug; and the factors influencing their willingness to prescribe the medication.

RESULTS

Healthcare professionals expressed considerable concern over using a polypill for primary prevention for all people over a specific age, although there was greater acceptance of its use for secondary prevention. Regularly monitoring patients taking the polypill was deemed essential. Evidence of effectiveness, patient risk level and potential medicalisation were key determinants in willingness to prescribe such a pill.

CONCLUSIONS

Primary healthcare professionals have significant concerns about the use of a polypill, particularly in the prevention of cardiovascular disease in people who are not regarded as being at 'high risk'. If a population-based polypill strategy is to be successfully implemented, healthcare professionals will need to be convinced of the potential benefits of a drug-based population approach to prevention.

Patients' beliefs about medicines in a primary care setting in Germany

OBJECTIVES

The aim of this study was to explore patients' beliefs about medicines by administering the German version of the Beliefs about Medicines Questionnaire (BMQ) in a primary care setting among chronically ill patients and to examine its psychometric properties. The BMQ assesses patients' beliefs about their individual prescribed medication as well as their beliefs about medicines in general.

METHODS

A cross-sectional survey of 485 chronically ill patients was performed. The German version of the BMQ was evaluated in terms of internal consistency, validity and scale structure. To assess validity the Medication Adherence Report Scale (MARS-D) and the Satisfaction with Information about Medicines Scale (SIMS-D) were applied.

RESULTS

The BMQ showed good internal consistency (Cronbach's α 0.79-0.83). Patients' belief about the specific necessity of their medicines correlated positively with the MARS-D (ρ = 0.202; P < 0.01). There were significant correlations in the predicted direction between the MARS-D and all the BMQ subscales with the exception of the General-Overuse subscale (ρ = -0.06; P = 0.30). Relationship to the SIMS-D was comparable to the original study. Factor analysis corroborated the scale structure.

CONCLUSIONS

The BMQ is a suitable instrument to measure patients' beliefs in medicines in German primary care settings. Most patients in our sample had positive beliefs concerning the necessity of their medication. Their levels of concern were associated with higher non-adherence.

Adaptation and validation study of the Beliefs about Medicines Questionnaire in psychiatric outpatients in a community mental health setting

PURPOSE

The present study aims to establish the factor structure and reliability of the Spanish version of the Beliefs about Medicines Questionnaire (BMQ), adapted to psychiatric medication, and to analyze the potential differences between psychiatric outpatients, medical students, and psychology students.

METHOD

The BMQ was tested on a sample of 405 psychiatric outpatients, 216 medical students, and 222 psychology students. Students completed only the BMQ-General scale, adapted for psychiatric medication, and patients completed also the BMQ-Specific scale.

RESULTS

For the BMQ-General scale adapted items, the analysis shows a two-factor structure similar to that described for the Spanish validation of the original instrument, but when samples are analyzed separately, relevant differences are observed in the composition of the factor structures. Furthermore, the resulting scales show a medium-low internal consistency. For BMQ-Specific scale items, the results replicate previous data. Medical students tend to consider psychiatric medication as less harmful and less likely to be overprescribed than psychology students, with patients' scores in the middle of both groups.

CONCLUSION

The BMQ-Specific scale has satisfactory psychometric properties for use in psychiatric outpatients in a community mental health setting. The adapted Spanish BMQ-General scale for psychotropics identified three different structures of the factors for each of the three samples studied.