AbstractsMedical & Health Science

Consumers' willingness to use Home Medicines Review

by Stephen R Carter




Institution: University of Sydney
Department:
Year: 2012
Keywords: Patient participation; Medication-related problem; Information seeking behaviour; Hassles; Medication review; FoR::111503 - Clinical Pharmacy and Pharmacy Practice; FoR::111708 - Health and Community Services; FoR::150501 - Consumer-Oriented Product or Service Development
Record ID: 1042503
Full text PDF: http://hdl.handle.net/2123/9336


Abstract

Throughout the world the population is ageing and the burden of chronic diseases and co- morbidity is growing. While the appropriate use of medicines help to decrease morbidity and mortality from chronic diseases, research consistently demonstrates that preventable medication-related problems cause unplanned hospitalisation and morbidity. The elderly and those consuming multiple medicines are at greatest risk. Pharmacist-provided medication management services aim to prevent and resolve medication-related problems for those consumers who have been identified as being at increased risk. This thesis deals with consumers' participation in pharmacist-provided medication management services with a particular focus on Australia's Home Medicines Review (HMR). HMR has been shown to improve health outcomes across a variety of research settings. The rationale for the thesis was that some consumers who have been identified as being at risk have declined the offer to use HMR. Many potential consumers of HMR are cared for by informal caregivers such as spouses or other family members (caregivers). Caregivers therefore necessarily have a key role in enhancing consumer participation in medication management services. Therefore, the aim of this thesis was to investigate consumers' and caregivers' awareness, expectations and willingness to use HMR. In order to address the aim, the thesis used cross sectional studies with mixed-methods. Studies included qualitative methods using focus group discussions and quantitative methods using surveys. Given the preliminary nature of the research, survey data was obtained from three different samples in order to validate the measurement scales and to test and re-test hypotheses. Such an approach strengthens the key findings of the thesis. Chapter One provides the background to the study. The literature review identified that consumers' most salient expectations of pharmacist-provided medication management services are those centred on the interpersonal interaction with the pharmacist during the patient-pharmacist interview. While it is acknowledged that these services improve medication safety through for example; enhanced inter-professional communication, goal setting, and optimised therapies, consumers tend to focus on the benefit of receiving personalised medicines information. Given the lack of previous research using behavioural theory to study the factors which influence willingness to use medication management services, a new framework was developed. The research was therefore guided by a conceptual model which was grounded in theories of medication information seeking behaviour. Chapter Two reports a cross-sectional survey which was distributed to patients by 264 pharmacists throughout Australia. A total of 1893 questionnaires for HMR recipients were sent to pharmacists of which 595 (31%) were returned by patients. A total of 1829 questionnaires for consumers who were eligible to use HMR (eligible non-recipients) were sent to pharmacists of which 293 (16%) were returned and met the…