title: Consumers' willingness to use a medication management service: the effect of medication-related worry and the social influence of the general practitioner.
abstract: BACKGROUND
  Some consumers at risk of experiencing medication-related problems have chosen not to use pharmacist-provided medication management services. Previous research has shown that consumers' willingness to use the Australian Home Medicines Review (HMR) service depends on the extent to which they believe that they will receive medication information to assist them with self-management.
  
  
  OBJECTIVE
  The aim of this study was to develop and test a model of willingness to use HMR among consumers who were eligible to receive the service but have not yet experienced it. Specifically, this study aimed to determine the effects of consumers' medication-related worry and the social influence of the consumer's general practitioner (GP) over willingness.
  
  
  METHODS
  A cross-sectional postal survey was conducted among 1600 members of Council on the Ageing (NSW, Australia). Respondents were included in the study if they had not experienced an HMR and were taking more than 5 medicines daily or more than 12 doses daily. Measurement scales were developed or were based on previous research. Confirmatory factor analysis was used to test the reliability and validity of the multi-item scales. Multiple regression analysis and structural equation modeling (SEM) were used to test the model.
  
  
  RESULTS
  Surveys received from 390 respondents (24.3%) were analyzed. Respondents held overall low-to-neutral positive outcome expectancy (POE). The SEM analysis revealed that worry had a direct effect on POE (β=0.35, P<.05) and an indirect effect on willingness (β=0.22, P<.05). Subjective norms had a direct effect on willingness (β=0.27, P<.05) but not POE. Worry was higher among those who had experienced a change in the medication regimen within the past 3 months (β=0.19, P<.001).
  
  
  CONCLUSIONS
  Those consumers who were worried about their medicines were more willing to use HMR. The consumer's GP appeared to exert a significant positive social influence over willingness to use this medication management service.
authors.affiliation: Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia. scar4376@uni.sydney.edu.au
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Carter
authors.forename: Rebekah J
authors.initials: RJ
authors.lastname: Moles
authors.forename: Lesley
authors.initials: L
authors.lastname: White
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D001294:Attitude to Health; D004363:Drug Utilization; D005260:Female; D058005:General Practitioners; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D054539:Medication Therapy Management; D008962:Models, Theoretical; D009517:New South Wales; D010358:Patient Participation; D024382:Professional Role