title: The effect of conflicting medication information and physician support on medication adherence for chronically ill patients.
abstract: 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.
authors.affiliation: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC 27599, USA. dlmiller@email.unc.edu
authors.forename: Delesha M
authors.initials: DM
authors.lastname: Carpenter
authors.forename: Robert F
authors.initials: RF
authors.lastname: DeVellis
authors.forename: Edwin B
authors.initials: EB
authors.lastname: Fisher
authors.forename: Brenda M
authors.initials: BM
authors.lastname: DeVellis
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hogan
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Jordan
mesh_terms: 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