Low alpha values could be indicative of certain items on the general overuse scale not measuring the same concept. This editing process was needed to create a Maltese text which is maximally suitable for the intended patients. Natural remedies were part of folklore which people in Malta moved away from upon introduction of what is today considered to be conventional medicine. Patient selection and recruitment Four different chronic illness groups were selected based on those selected by Horne et al. The principal investigator asked the patients for a few minutes of their time, explained to them that she was conducting a study on the beliefs about medicines and asked them if they would be kind enough to fill in the questionnaire.
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Search Menu Abstract Objectives. To investigate beliefs about medications held by people with rheumatoid arthritis RA , what factors are related to these specific medication beliefs, and whether these beliefs influence adherence. The design was a cross-sectional postal questionnaire survey of people with RA. The Beliefs about Medicines Questionnaire was used to assess beliefs about the necessity of medication and concerns about it.
Questionnaires were mailed to out-patients with RA. The response rate was Most However, The overall necessity score mean Concerns scores for non-adherent participants mean Most people with RA have positive beliefs about the necessity of their medication. However, levels of concern are high and associate with helplessness and non-adherence.
The Beliefs about Medicines Questionnaire may identify people at risk of poor adherence and provide a focus for patients to discuss their beliefs, providing opportunities to improve adherence. Rheumatoid arthritis , Beliefs about medicines , Knowledge , Adherence Beliefs and attitudes about illness influence adherence to treatment [ 1 , 2 ]. In fact, beliefs about medicines predict adherence more strongly than sociodemographic or clinical factors [ 2 ].
Non-adherence may result in unnecessary health costs, investigations, changes in treatment, morbidity and mortality [ 5 ]. Investigating medication beliefs is especially important in rheumatoid arthritis RA as it is a chronic disease, and people are usually advised to take potentially toxic drugs, including non-steroidal anti-inflammatory drugs NSAIDs and disease-modifying anti-rheumatic drugs DMARDs , which may be only partially effective.
Being able to identify people with RA at risk of medication non-adherence could assist in the design and appropriately timed delivery of interventions to increase adherence, thus improving health status and reducing costs. There is a relative paucity of information regarding the medication beliefs held by people with RA. Two recent studies have investigated these. Berry et al. Perceived benefits of medication were primarily reduction of pain, stiffness and swelling, and perceived risks were primarily side-effects and becoming dependent on drugs.
Although existing patients perceived their medications to be significantly more risky than did new patients, these concerns were still only at modest levels. Participants expressed strong concerns about taking their medications, particularly with regard to potential toxicity and long-term effects.
This study emphasized the tension experienced by people with RA with respect to the importance of their medication and their concerns about it. Social cognition theories of health behaviour e. Self-regulatory theory also emphasizes that treatment perceptions and illness representations influence medication adherence [ 8 ]. These theories propose that people undertake a cost—benefit analysis, considering whether their beliefs about the necessity of medications for maintaining health outweigh their concerns about the potential adverse effects of taking them.
It has been validated for use in patients with chronic illnesses and has been shown to predict adherence to treatment amongst other groups, e. People with strong beliefs in the necessity of taking medication to maintain their health were found to be more adherent to treatment, and those with higher levels of concern about medication, commonly about the dangers of dependence and long-term side-effects, were more likely to be non-adherent [ 2 ].
The aims of this study were to use the BMQ to investigate the beliefs about medications held by people with RA. We also investigated what factors are related to these specific medication beliefs, and whether these beliefs influence adherence to drug treatments. Methods A self-report questionnaire was used to collect data on six key areas. Scores obtained for individual items within both scales are summed. Thus, total scores for the Necessity and Concerns Scales range from 5 to Higher scores indicate stronger beliefs.
This differential can be thought of as the cost—benefit analysis for each patient, for whom costs concerns are weighed against their perceived benefits necessity beliefs [ 2 ].
Sociodemographic factors These are age, gender, highest educational level achieved and current employment status. Disease features Self-reported duration of RA was recorded. This includes the modified Health Assessment Questionnaire mHAQ, score range 1—4 , mm visual analogue scales VAS for pain and fatigue, a psychological distress scale consisting of four items: stress, anxiety, depression and sleep quality, score range 1—4 and a Rheumatology Attitudes Index RAI, score range 5—40 [ 11—13 ].
Higher scores indicate greater levels of helplessness. Participants responded on a five-point scale strongly disagree to strongly agree. This consists of 11 items assessing general knowledge about RA and drug treatments. A percentage score is calculated.
Participants The questionnaire was piloted with 10 out-patients with RA and subsequently modified to improve clarity. The database was sorted in alphabetical order by surname and the first people were selected. Freepost envelopes were provided for return of the questionnaires. The LREC required all replies to be anonymous, and so no reminders to non-respondents could be sent.
Data distributions were normal and therefore parametric analysis was conducted. Bivariate correlations were used to examine the associations of concerns scores and necessity scores with the variables of interest sociodemographic, disease-related, DMARD-related and knowledge of RA.
Partial correlations were used to further examine these associations with the remaining variables held constant. For nominal variables e. Results Response rate Three hundred and forty-four of questionnaires were returned, a response rate of Some respondents did not complete every questionnaire item. Non-respondents were similar to the total sample mailed in terms of age and gender. The median disease duration was The mean mHAQ score was 1.
The mean fatigue VAS was The mean RAI score was The mean RA knowledge score was Beliefs about medicines scores The majority of the sample Medication was considered important for both the maintenance of current health and for future health. However, overall Another area of concern was becoming dependent upon medications Table 1. Percentage agreeing or strongly agreeing.
Beliefs about Medicines Questionnaire (BMQ)
Waleed M. E-mail: moc. This article has been cited by other articles in PMC. Abstract Background: Identifying factors associated with adherence is of great value in clinical practice. The objective of this study was to investigate medication adherence, beliefs about medicines held by people with chronic illness and whether beliefs influence medication adherence. The beliefs about medicines questionnaire was used to assess beliefs and Morisky medication adherence scale was used to assess adherence. Results: A total of patients were interviewed.