The effect of conflicting medication information and physician support on medication adherence for chronically ill patients.
OBJECTIVE
This article explores the effect of conflicting information, defined as contradictory information about medication topics from different sources, on medication adherence in a sample of chronically ill patients. We specifically investigate whether conflicting information and physician support directly affect medication adherence or whether the effect is mediated by adherence self-efficacy and outcome expectations for medications.


METHODS
Vasculitis patients (n = 228) completed two on-line questionnaires which contained measures of conflicting information, adherence self-efficacy, outcome expectations, physician support, and medication adherence. We conducted a mediation analysis using a bootstrapping approach to generate point estimates and 95% confidence intervals to test the significance of each mediated effect.


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 physician support on medication adherence.


CONCLUSIONS
Patients who encounter conflicting medication information are less adherent to their medications. The presence of a supportive physician may counteract the negative effect of conflicting medication information.


CONCLUSIONS
Physicians should initiate conversations about conflicting medication information with their patients. Consensus-based guidelines that address medication discrepancies may also reduce the availability of conflicting information.
Carpenter
Delesha M
DM
Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC 27599, USA. dlmiller@email.unc.edu
DeVellis
Robert F
RF
Fisher
Edwin B
EB
DeVellis
Brenda M
BM
Hogan
Susan L
SL
Jordan
Joanne M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000188:drug therapy* / Q000523:psychology; D003220:Conflict, Psychological; D004346:Drug Information Services; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination; D057226:Information Seeking Behavior; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D014657:Vasculitis / Q000188:drug therapy*; D055815:Young Adult