title: Beliefs about medication predict the misattribution of a common symptom as a medication side effect--Evidence from an analogue online study.
abstract: OBJECTIVE
  Some perceived medication side effects may be 'normal' symptoms that patients misattribute to the medication. Using an analogue approach, we tested if medication beliefs predict whether participants misattribute a headache as a side effect and subsequently intend to stop medication.
  
  
  METHODS
  We recruited 690 participants, 223 reporting a past asthma diagnosis. They received information about asthma and Molair, a fictitious asthma treatment modeled on a licensed treatment (montelukast). We varied the description of efficacy and side effects (which did not include headache). Pre-exposure to this information, participants completed the Beliefs about Medicine Questionnaire (BMQ)-General and the Perceived Sensitivity to Medicines Scale (PSM), post-exposure they completed the BMQ-Specific. Participants were asked to imagine they experienced a headache while taking Molair. Finally, they rated whether the headache was a side effect (misattribution) and if they would stop taking Molair (behavioral intention).
  
  
  RESULTS
  Nearly a quarter (170) of participants misattributed the headache to Molair and 69 (10%) subsequently intended to stop Molair. Both outcomes were predicted by general and specific medication beliefs. Odds of misattribution (m) and behavioral intention (i) increased with higher General Harm (ORm=1.90, ORi=2.72), General Overuse (ORm=1.74, ORi=1.56) and Molair Concern beliefs (ORm=1.52, ORi=1.78, all p<.01), but decreased with General Benefit (ORm=0.72, ORi=0.53) and Molair Necessity beliefs (ORm=0.72, ORi=0.70, all p<.05).
  
  
  CONCLUSIONS
  Symptom misattribution and subsequent intentions to stop Molair were predicted by pre-exposure beliefs about medicines in general and post-exposure beliefs about Molair. Patients with negative medication beliefs may be prone to misattribute symptoms and subsequently stop medication.
authors.affiliation: Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, United Kingdom.
authors.forename: Monika K
authors.initials: MK
authors.lastname: Heller
authors.affiliation: Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, United Kingdom.
authors.forename: Sarah C E
authors.initials: SC
authors.lastname: Chapman
authors.affiliation: Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, United Kingdom. Electronic address: r.horne@ucl.ac.uk.
authors.forename: Rob
authors.initials: R
authors.lastname: Horne
mesh_terms: D000085:Acetates / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy; D003521:Cyclopropanes; D064420:Drug-Related Side Effects and Adverse Reactions; D019317:Evidence-Based Medicine; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011804:Quinolines / Q000008:administration & dosage / Q000009:adverse effects; D013440:Sulfides; D011795:Surveys and Questionnaires
chemical_list: D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; C093875:montelukast
keywords: Adherence; Asthma; Attribution; Beliefs about medicines; Nocebo; Side effects