Skip to main content

Advertisement

SpringerLink
Log in

Exploring patients’ motivation to participate in Australia’s Home Medicines Review program

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Patients at risk of experiencing medicine-related problems do not always appear willing to participate in collaborative medication management services. Little is known about the psycho-social factors which motivate patients to participate in these services. The theory of motivated information management (TMIM) suggests that patients’ willingness to participate may be motivated by their uncertainty and worry about their medicines. Objective The objective of this study was to investigate factors which may motivate patients to participate in a collaborative medication management program. Setting Fourteen semi-structured focus group interviews held throughout Australia provided the data for the study. Eighty participants were recruited by community pharmacists. Participants were recruited into the study if they had experienced Australia’s Home Medicines Review (HMR) program or would be eligible to participate in the program because they were at risk of experiencing medicine-related problems. Methods An interview guide was developed which was informed by TMIM. Focus group data were audio-recorded, transcribed and where necessary, translated into English. Main outcome measure Qualitative data were thematically analysed to identify participants’ expectations about the outcomes of HMR and the factors which may influence these expectations. Results Participants’ most salient outcome expectancies of HMR were that it was a medication-information source which would assist them to manage their medicines. Recipients of the program held overall positive outcome expectancies, whereas nonrecipients’ expectancies varied widely. Consistent with theory, participants who expressed some worry about their medicines, generally held positive outcome expectancies and were willing to participate in HMR. Compared with younger participants, older participants (those aged >74 years) tended to engage less in their thoughts about being at risk, and consequently did not experience worry. Conclusion Worry about medicines is a key factor in motivating participants to engage in medicines information-seeking. Older persons who rely heavily on heuristics appeared less likely to worry about their medicines and willing to participate in medication management services. Age-related reduction in the motivation to participate may have important implications for medication safety. Further examination of this effect is warranted because older persons are at greatest risk of medicine related problems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Uijen AA, van de Lisdonk EH. Multimorbidity in primary care: prevalence and trend over the last 20 years. Eur J Gen Pract. 2008;14(Suppl 1):28–32.

    Article  PubMed  Google Scholar 

  2. Junius-Walker U, Voigt I, Wrede J, Hummers-Pradier E, Lazic D, Dierks M-L. Health and treatment priorities in patients with multimorbidity: report on a workshop from the European General Practice Network meeting ‘Research on multimorbidity in general practice’. Eur J Gen Pract. 2010;16(1):51–4.

    Article  PubMed  Google Scholar 

  3. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3(3):223–8.

    Article  PubMed  Google Scholar 

  4. Britt HC, Harrison CM, Miller GC, Knox SA. Prevalence and patterns of multimorbidity in Australia. Med J Aust. 2008;189(2):72–7.

    PubMed  Google Scholar 

  5. Vitry AI, Zhang Y. Quality of Australian clinical guidelines and relevance to the care of older people with multiple comorbid conditions. Med J Aust. 2008;189(7):360–5.

    PubMed  Google Scholar 

  6. Moen J, Antonov K, Larsson CA, Lindblad U, Nilsson JLG, Rastam L, et al. Factors associated with multiple medication use in different age groups. Ann Pharmacother. 2009;43(12):1978–85.

    Article  PubMed  Google Scholar 

  7. Miller GC, Britt HC, Valenti L. Adverse drug events in general practice patients in Australia. Med J Aust. 2006;184(7):321.

    PubMed  Google Scholar 

  8. Semple S, Roughead E. Medication safety in acute care in Australia: where are we now? Part 2: a review of strategies and activities for improving medication safety 2002–2008. Aust New Zealand Health Policy. 2009;6(1):24.

    Article  PubMed  Google Scholar 

  9. Australian Government Medicare. Home Medicines Reviews. 2011; Available from: Available online at: www.medicareaustralia.gov.au/provider/pbs/fifth-agreement/home-medicines-review.jsp. Accessed: 24th Jan 2011.

  10. Nishtala PS, McLachlan AJ, Bell JS, Chen TF. A retrospective study of drug-related problems in Australian aged care homes: medication reviews involving pharmacists and general practitioners. J Eval Clin Pract. 2011;17(1):97–103.

    Article  PubMed  Google Scholar 

  11. Ellitt G, Engblom E, Aslani P, Westerlund T, Chen T. Drug related problems after discharge from an Australian teaching hospital. Pharm World Sci. 2010;32(5):622–30.

    Article  PubMed  Google Scholar 

  12. Castelino RL, Bajorek BV, Chen TF. Are interventions recommended by pharmacists during Home Medicines Review evidence-based? J Eval Clin Pract. 2010;17(1):104–11.

    Article  PubMed  Google Scholar 

  13. Castelino RL, Bajorek BV, Chen TF. Retrospective evaluation of Home Medicines Review by pharmacists in older Australian patients using the medication appropriateness index. Ann Pharmacother. 2010;44(12):1922–9.

    Article  PubMed  Google Scholar 

  14. Castelino RL, Hilmer SN, Bajorek BV, Nishtala P, Chen TF. Drug burden index and potentially inappropriate medications in community-dwelling older people: the impact of Home Medicines Review. Drugs Aging. 2010;27(2):135–48.

    Article  PubMed  Google Scholar 

  15. Castelino RL, Chen TF, Guddattu V, Bajorek BV. Use of evidence-based therapy for the prevention of cardiovascular events among older people. Eval Health Prof. 2010;33(3):276–301.

    Article  PubMed  Google Scholar 

  16. Roughead EE, Barratt JD, Ramsay E, Pratt N, Ryan P, Peck R, et al. The effectiveness of collaborative medicine reviews indelaying time to next hospitalization for patients with heart failure in the practice setting. Circ Heart Fail. 2009;2(5):424–8.

    Article  PubMed  Google Scholar 

  17. Vincent CA, Coulter A. Patient safety: what about the patient? Qual Saf Health Care. 2002;11(1):76–80.

    Article  PubMed  CAS  Google Scholar 

  18. Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol. 2008;65(3):303–16.

    Article  PubMed  Google Scholar 

  19. Chen T, Larkin CA. Consumer attitudes toward and experiences of domiciliary visits by community pharmacists. Aust Pharm. 2002;21(9):682–8.

    Google Scholar 

  20. Ponniah A, Shakib S, Doecke CJ, Boyce M, Angley M. Post-discharge medication reviews for patients with heart failure: a pilot study. Pharm World Sci. 2008;30(6):810–5.

    Article  PubMed  Google Scholar 

  21. Kyle G, Nissen L. A community nurse referral system for HMRs—can it work? Aust Pharm. 2006;25(4):326–32.

    Google Scholar 

  22. Carter S, Chen T, White L. Home Medicines Reviews: a quantitative study of the views of recipients and eligible non-recipients. Int J Pharm Pract. 2011. doi:10.1111/j.2042-7174.2011.00180.x.

  23. Law AV, Okamoto MP, Brock K. Perceptions of medicare part D enrollees about pharmacists and their role as providers of medication therapy management. J Am Pharm Assoc. 2008;48(5):648–53.

    Article  Google Scholar 

  24. Latif A, Pollock K, Boardman H. Why do patients accept or decline the invitation for a Medicines Use Review? Int J Pharm Pract. 2010;18:21.

    Google Scholar 

  25. Lenz ER. Information seeking: a component of client decisions and health behavior. ANS Adv Nurs Sci. 1984;6(3):59–72.

    PubMed  CAS  Google Scholar 

  26. Raynor DK, Blenkinsopp A, Knapp P, Grime J, Nicolson DJ, Pollock K, et al. A systematic review of quantitative and qualitative research on the role and effectiveness of written information available to patients about individual medicines. Health Technol Assess. 2007;11(5):1–160.

    Google Scholar 

  27. Afifi WA, Weiner JL. Seeking information about sexual health: applying the theory of motivated information management. Hum Commun Res. 2006;32(1):35–57.

    Article  Google Scholar 

  28. Afifi WA, Weiner JL. Toward a theory of motivated information management. Commun Theory. 2004;14(2):167–90.

    Article  Google Scholar 

  29. Australian Bureau of Statistics. Census of population and housing. 2006. Available online at: www.abs.gov.au/websitedbs/d3310114.nsf/Home/census. Accessed: 26th March 2011.

  30. Gordon K, Smith F, Dhillon S. Effective chronic disease management: patients’ perspectives on medication-related problems. Patient Educ Couns. 2007;65(3):407–15.

    Article  PubMed  Google Scholar 

  31. Moen J, Bohm A, Tillenius T, Antonov K, Nilsson JLG, Ring L. “I don’t know how many of these [medicines] are necessary.”—A focus group study among elderly users of multiple medicines. Patient Educ Couns. 2009;74(2):135–41.

    Article  PubMed  Google Scholar 

  32. Huston SA, Hobson EH. Using focus groups to inform pharmacy research. Res Soc Adm Pharm. 2008;4(3):186–205.

    Article  Google Scholar 

  33. Carey M. The group effect in focus groups: planning, implementing, and interpreting focus group research. In: Morse J, editor. Critical issues in qualitative research methods. London: Sage; 1994. p. 225–41.

    Google Scholar 

  34. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.

    Article  Google Scholar 

  35. Montgomery AT, Kälvemark Sporrong S, Manap N, Tully MP, Lindblad ÅK. Receiving a pharmaceutical care service compared to receiving standard pharmacy service in Sweden-How do patients differ with regard to perceptions of medicine use and the pharmacy encounter? Res Soc Adm Pharm. 2010;6(3):185–95.

    Article  Google Scholar 

  36. Levy BH. Self-administered medication-risk questionnaire in an elderly population. Ann Pharmacother. 2003;37(7–8):982–7.

    Article  Google Scholar 

  37. Koecheler JA, Abramowitz PW, Swim SE, Daniels CE. Indicators for the selection of ambulatory patients who warrant pharmacist monitoring. Am J Hosp Pharm. 1989;46(4):729–32.

    PubMed  CAS  Google Scholar 

  38. Forster AJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003;138(3):161–7.

    PubMed  Google Scholar 

  39. Sikdar KC, Alaghehbandan R, MacDonald D, Barrett B, Collins KD, Donnan J, et al. Adverse drug events in adult patients leading to emergency department visits. Ann Pharmacother. 2010;44(4):641–9.

    Article  PubMed  Google Scholar 

  40. Lockenhoff CE, Carstensen LL. Aging, emotion, and health-related decision strategies: motivational manipulations van reduce age differences. Psychol Aging. 2007;22(1):134–46.

    Article  PubMed  Google Scholar 

  41. Williams AF, Manias E, Walker R. The role of irrational thought in medicine adherence: people with diabetic kidney disease. J Adv Nurs. 2009;65(10):2108–17.

    Article  PubMed  Google Scholar 

  42. Lloyd A. The extent of patient’s understanding of the risk of treatments. Qual Health Care. 2001;10(Suppl. 1):i14–8.

    PubMed  Google Scholar 

  43. Say R, Murtagh M, Thomson R. Patients’ preference for involvement in medical decision making: a narrative review. Patient Educ Couns. 2006;60(2):102–14.

    Article  PubMed  Google Scholar 

  44. Miller MJ, Schmitt MR, Allison JJ, Cobaugh DJ, Ray MN, Saag KG. The role of health literacy and written medicine information in nonsteroidal antiinflammatory drug risk awareness. Ann Pharmacother. 2010;44(2):274–84.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank all participants for their time and contribution to this study, as well as the community pharmacists who assisted with recruitment. We are grateful to Christiane Klinner who coordinated the project, and to Simone Goppert who assisted with the preparation of the manuscript.

Funding

This project was funded by the Australian Government Department of Health and Ageing, as part of the Fourth Community Pharmacy Agreement Research & Development Program managed by the Pharmacy Guild of Australia.

Conflicts of interest

There are no conflicts of interest in authorship of this article.

Author information

Authors and Affiliations

  1. Faculty of Pharmacy, The University of Sydney, Room 515 Pharmacy and Bank Building A15, Sydney, NSW, 2006, Australia

    Stephen R. Carter & Rebekah Moles

  2. Faculty of Business, Charles Sturt University, Bathurst, NSW, 2795, Australia

    Lesley White

  3. Faculty of Pharmacy, The University of Sydney, Room 511 Pharmacy and Bank Building A15, Sydney, NSW, 2006, Australia

    Timothy F. Chen

Authors
  1. Stephen R. Carter
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rebekah Moles
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lesley White
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Timothy F. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephen R. Carter.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carter, S.R., Moles, R., White, L. et al. Exploring patients’ motivation to participate in Australia’s Home Medicines Review program. Int J Clin Pharm 34, 658–666 (2012). https://doi.org/10.1007/s11096-012-9661-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-012-9661-z

Keywords

Search

Navigation