Development and validation of a patient medication risk reduction behavior scale and application in a managed care population
Abstract
The purpose of this study was to develop an instrument for assessing levels of patient medication risk reduction behaviors and apply that instrument to determine the extent to which patients currently engage in those behaviors. Instrument developed also was used to assess effects of a patient safety education program, designed to educate patients about these behaviors and encourage their participation in managing their medications. An instrument for measuring levels of patient medication risk reduction behaviors was developed based on behaviors identified by national experts as reducing risks. The survey instrument was mailed to 4,000 individuals, 2,000 each in intervention group and primary control group selected randomly from members of a prescription benefit plan. An intervention consisting of a brochure and a wallet card was mailed to respondents in the intervention group who had responded to the pre-intervention survey. A post-intervention survey was mailed to individuals in the intervention group and the primary control group who responded to the pre-intervention survey and individuals in a secondary control group that had not been previously surveyed. The patient medication risk reduction scale was analyzed using exploratory factor analysis with promax rotation. Internal consistency of the scale and its subscales was determined using Cronbach's alpha and item-total correlations. Changes in overall mean scale scores from pre-intervention to post-intervention were compared between the intervention group and the primary control group to determine the effect of intervention. Relationships between demographic variables and overall scale scores were assessed with one-way analysis of variance. Factor analysis reduced the preliminary 22 medication behavior items to a final scale of 18 items with four subscales: “asking,” “telling,” “writing” and “ensuring understanding”. The reliability of the scale measured by Cronbach's alpha was 0.89. Patients performed behaviors related to writing medication-related information less frequently than behaviors related to understanding medication-related information. The frequency of medication risk reduction behaviors increased with increase in age of respondents. The relationship remained after controlling for all other demographic variables. Exposure of respondents to survey significantly increased medication risk reduction behaviors. However, the informational brochure did not have any significant additional impact on medication risk reduction behaviors.
Degree
Ph.D.
Advisors
Thomas, Purdue University.
Subject Area
Health care|Public health|Health education
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