title: Exploring beliefs about heart failure treatment in adherent and nonadherent patients: use of the repertory grid technique.
abstract: OBJECTIVE
  Beliefs about medicines impact on adherence, but eliciting core beliefs about medicines in individual patients is difficult. One method that has the potential to elicit individual core beliefs is the "repertory grid technique." This study utilized the repertory grid technique to elicit individuals' beliefs about their heart failure treatment and to investigate whether generated constructs were different between adherent and nonadherent patients.
  
  
  METHODS
  Ninety-two patients with heart failure were interviewed using a structured questionnaire that applied the repertory grid technique. Patients were asked to compare and contrast their medicines and self-care activities for their heart failure. This lead to the generation of individual constructs (perceptions towards medicines), and from these, beliefs were elicited about their heart failure treatment, resulting in the generation of a repertory grid. Adherence was measured using the Medication Adherence Report Scale (MARS). Patients with a MARS score ≥ 23 were categorized as "adherent" and those with a score ≤ 22 as "nonadherent." The generated grids were analyzed descriptively and constructs from all grids themed and the frequency of these constructs compared between adherent and nonadherent patients.
  
  
  RESULTS
  Individual grids provided insight into the different beliefs that patients held about their heart failure treatment. The themed constructs "related to water," "affect the heart," "related to weight," and "benefit to the heart" occurred more frequently in adherent patients compared with nonadherent patients.
  
  
  CONCLUSIONS
  The repertory grid technique elicited beliefs of individual participants about the treatment of their heart failure. Constructs from self-reported adherent patients were more likely to reflect that their medicines and self-care activities were related to water and weight, and affect and benefit to the heart. Providing clinicians with better insight into individuals' beliefs about their treatment may facilitate the development of tailored interventions to improve adherence.
authors.affiliation: School of Pharmacy, University of Queensland, Brisbane, Qld, Australia.
authors.forename: William Neil
authors.initials: WN
authors.lastname: Cottrell
authors.forename: Charles P
authors.initials: CP
authors.lastname: Denaro
authors.forename: Lynne
authors.initials: L
authors.lastname: Emmerton
keywords: adherence; beliefs; heart failure; repertory grid; treatment
references.citation: J Card Fail. 2008 Apr;14(3):203-10
references.pmid: 18381183
references.citation: J Card Fail. 2008 Sep;14(7):603-14
references.pmid: 18722327
references.citation: Heart Lung. 2002 May-Jun;31(3):161-72
references.pmid: 12011807
references.citation: Am J Gastroenterol. 2007 Jul;102(7):1417-26
references.pmid: 17437505
references.citation: JAMA. 2002 Feb 20;287(7):883-9
references.pmid: 11851582
references.citation: JAMA. 1995 May 10;273(18):1450-6
references.pmid: 7654275
references.citation: Soc Sci Med. 2004 Feb;58(3):631-43
references.pmid: 14652059
references.citation: Int J Cardiol. 2008 Apr 10;125(2):203-8
references.pmid: 18031843
references.citation: Pain Pract. 2009 Jan-Feb;9(1):1-7
references.pmid: 19019056
references.citation: Inflamm Bowel Dis. 2009 Jun;15(6):837-44
references.pmid: 19107771
references.citation: Eur Heart J. 2006 Feb;27(4):434-40
references.pmid: 16230302
references.citation: Eur J Heart Fail. 1999 Jun;1(2):145-9
references.pmid: 10937924
references.citation: Chest. 2005 Nov;128(5):3198-204
references.pmid: 16304262
references.citation: Ann Pharmacother. 2008 Jan;42(1):39-45
references.pmid: 18073328
references.citation: Heart Lung. 2001 May-Jun;30(3):177-85
references.pmid: 11343003
references.citation: Ann Pharmacother. 2006 Oct;40(10):1737-42
references.pmid: 16985088
references.citation: Br J Clin Pharmacol. 2007 Apr;63(4):488-93
references.pmid: 17076693
references.citation: J Psychosom Res. 2005 May;58(5):403-15
references.pmid: 16026655
references.citation: N Z Med J. 2008 Nov 07;121(1286):14-20
references.pmid: 19098944
references.citation: Complement Ther Med. 2002 Jun;10(2):69-77
references.pmid: 12481954
references.citation: Med Care. 2005 Dec;43(12):1203-7
references.pmid: 16299431
references.citation: J Affect Disord. 2009 Jul;116(1-2):51-5
references.pmid: 19101038
references.citation: Heart Lung. 2001 Sep-Oct;30(5):351-9
references.pmid: 11604977
references.citation: Qual Saf Health Care. 2004 Jun;13(3):172-5
references.pmid: 15175485
references.citation: Patient Educ Couns. 2006 Jun;61(3):348-53
references.pmid: 16139468
references.citation: Arch Intern Med. 2001 Oct 22;161(19):2337-42
references.pmid: 11606149
references.citation: Soc Sci Med. 2005 Jun;60(11):2585-95
references.pmid: 15814183
references.citation: Int J Clin Pharm. 2012 Aug;34(4):618-25
references.pmid: 22717778
references.citation: Adv Ther. 2005 Jul-Aug;22(4):313-56
references.pmid: 16418141
references.citation: Eur J Heart Fail. 2003 Jun;5(3):371-80
references.pmid: 12798837
references.citation: Patient Educ Couns. 2002 Apr;46(4):287-95
references.pmid: 11932128
references.citation: Br J Clin Psychol. 2001 Sep;40(3):225-48
references.pmid: 11593952
references.citation: Heart Lung. 2007 Jul-Aug;36(4):253-61
references.pmid: 17628194
references.citation: Arch Intern Med. 1999 Jul 26;159(14):1613-9
references.pmid: 10421285
references.citation: Eur J Heart Fail. 2002 Jun;4(3):283-7
references.pmid: 12034153
references.citation: Pediatrics. 2007 Sep;120(3):e521-6
references.pmid: 17766496
references.citation: Psychol Health. 2010 Jun;25(5):601-15
references.pmid: 20204936
references.citation: Patient Educ Couns. 2006 Dec;64(1-3):50-60
references.pmid: 16843634
references.citation: Am J Med. 2003 Jun 1;114(8):625-30
references.pmid: 12798449
references.citation: J Psychosom Res. 2008 Jan;64(1):47-54
references.pmid: 18157999
references.citation: Curr Med Res Opin. 2008 Jul;24(7):2127-38
references.pmid: 18554431
references.citation: J Clin Pharm Ther. 2001 Oct;26(5):331-42
references.pmid: 11679023
references.citation: Pharm World Sci. 2007 Apr;29(2):73-80
references.pmid: 17187220
references.citation: Patient Educ Couns. 2007 Dec;69(1-3):158-64
references.pmid: 17913439
references.citation: Curr Med Res Opin. 2009 Jan;25(1):215-38
references.pmid: 19210154