Understanding the effect of conflicting information on medication adherence for vasculitis patients Public Deposited

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  • March 22, 2019
Creator
  • Carpenter, Delesha Miller
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
Abstract
  • Introduction. This dissertation represents the first quantitative investigation of the effect of conflicting information on medication adherence in a sample of chronically ill patients. Using the Information-Motivation-Behavioral Skills model as a theoretical guide, the primary aim was to explore the relationships between conflicting information, adherence support, outcome expectations for medications, adherence self-efficacy, and medication adherence. A secondary aim was to describe patients' most frequently used information sources, determine which sources patients perceived as credible, and investigate whether there were gender differences in the use and perceived credibility of sources. Methods. Vasculitis patients (n=232) completed two online questionnaires as part of the Accessing Social Support in Symptom Treatment Study. A bootstrapping approach was used to determine whether self-efficacy and outcome expectations mediated the effects of conflicting information and adherence support on medication adherence. For the second aim, MANCOVA tested the significance of a source*gender interaction term and follow-up contrasts determined which sources male and female patients used differently. T-tests compared patients' perceived credibility ratings. 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 adherence support on medication adherence. Patients used physicians and the Internet most often to obtain medication information and also rated them as the two most credible information sources. Male patients consulted their spouse/partner more often and rated them as more credible than female patients. Female patients were more likely to use medication package inserts and the Internet and less likely to consult nurses than male patients. Conclusion. Vasculitis patients seek medication information from multiple sources, which can result in the discovery of conflicting information. Patients who receive conflicting medication information are less adherent to their medication regimens. Policy initiatives to standardize medication practices may reduce the amount of conflicting information available to patients. Future research should attempt to uncover the determinants and outcomes, both immediate and distal, of receiving conflicting information and explore whether conflicting information is an issue for other disease populations.
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  • In Copyright
Advisor
  • DeVellis, Robert F.
Degree granting institution
  • University of North Carolina at Chapel Hill
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  • Open access
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