title: Words that make pills easier to swallow: a communication typology to address practical and perceptual barriers to medication intake behavior.
abstract: OBJECTIVE
  The barriers to patients' successful medication intake behavior could be reduced through tailored communication about these barriers. The aim of this study is therefore (1) to develop a new communication typology to address these barriers to successful medication intake behavior, and (2) to examine the relationship between the use of the typology and the reduction of the barriers to successful medication intake behavior.
  
  
  METHODS
  Based on a literature review, the practical and perceptual barriers to successful medication intake behavior typology (PPB-typology) was developed. The PPB-typology addresses four potential types of barriers that can be either practical (memory and daily routine barriers) or perceptual (concern and necessity barriers). The typology describes tailored communication strategies that are organized according to barriers and communication strategies that are organized according to provider and patient roles. Eighty consultations concerning first-time medication use between nurses and inflammatory bowel disease patients were videotaped. The verbal content of the consultations was analyzed using a coding system based on the PPB-typology. The Medication Understanding and Use Self-efficacy Scale and the Beliefs about Medicine Questionnaire Scale were used as indicators of patients' barriers and correlated with PPB-related scores.
  
  
  RESULTS
  The results showed that nurses generally did not communicate with patients according to the typology. However, when they did, fewer barriers to successful medication intake behavior were identified. A significant association was found between nurses who encouraged question-asking behavior and memory barriers (r = -0.228, P = 0.042) and between nurses who summarized information (r = -0.254, P = 0.023) or used cartoons or pictures (r = -0.249, P = 0.026) and concern barriers. Moreover, a significant relationship between patients' emotional cues about side effects and perceived concern barriers (r = 0.244, P = 0.029) was found as well.
  
  
  CONCLUSIONS
  The PPB-typology provides communication recommendations that are designed to meet patients' needs and assist providers in the promotion of successful medication intake behavior, and it can be a useful tool for developing effective communication skills training programs.
authors.affiliation: Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Annemiek J
authors.initials: AJ
authors.lastname: Linn
authors.forename: Julia Cm
authors.initials: JC
authors.lastname: van Weert
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Schouten
authors.forename: Edith G
authors.initials: EG
authors.lastname: Smit
authors.forename: Ad A
authors.initials: AA
authors.lastname: van Bodegraven
authors.forename: Liset
authors.initials: L
authors.lastname: van Dijk