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Medication Literacy and Empowerment in the Misuse of Prescription Drugs

English title Medication Literacy and Empowerment in the Misuse of Prescription Drugs
Applicant Nakamoto Kent
Number 146980
Funding scheme Project funding (Div. I-III)
Research institution Istituto Media e Giornalismo Facoltà di Scienze della comunicazione Università della Svizzera italiana
Institution of higher education Università della Svizzera italiana - USI
Main discipline Communication sciences
Start/End 01.09.2013 - 30.04.2017
Approved amount 346'773.00
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Keywords (4)

empowerment; health literacy; adherence; prescription medication

Lay Summary (Italian)

Lead
I farmaci soggetti a preiscrizione medica rappresentano degli strumenti di vitale importanza nelle terapie medica. Ciononostante, la metà dei pazienti ai quali è stata prescritta l’assunzione di farmaci per vari disturbi di salute non si attiene alle indicazioni fornite dal medico riguardo all’uso dei propri medicamenti. Ciò pone il paziente a rischio di complicazioni e crea un serio problema di gestione per i professionisti della salute.
Lay summary

Obiettivi di ricerca

In modo da esaminare questo problema, saranno svolti tre studi allo scopo di esplorare il ruolo svolto da cultura della salute e d’empowerment sull’aderenza del paziente rispetto alle indicazioni fornite per l’assunzione di farmaci. Nel primo studio, verranno intervistati pazienti che soffrono d’ipertensione e di dolori cronici per meglio comprendere la loro condizione di salute, i medicinali prescritti (benefici e potenziali effetti collaterali), le loro emozioni rispetto al medicamento, le modalità di utilizzo e qualsiasi “mito” i pazienti abbiano riguardo al farmaco. Il secondo studio si baserà su quanto emerso nello studio 1 per identificare i fattori che determinano l’aderenza alla prescrizione medica e la qualità di vita. Nel terzo studio, verranno utilizzati i risultati individuati nello studio 2 per sviluppare interventi volti a migliorare la cultura della salute e l’empowerment e testare il loro impatto e la loro interazione nell’incrementare l’aderenza al trattamento farmacologico prescritto.

Contributi

Il presente studio sarà il primo a testare il modello teorico esteso sviluppato dai ricercatori su cultura della salute, empowerment e sui loro effetti rispetto all’adozione di un determinato comportamento nell’ambito della salute. Lo studio contribuirà ad aumentare le conoscenze sulle motivazioni che spingono il paziente a deviare da quanto inizialmente prescritto dal medico e quindi ad affrontare una problematica potenzialmente molto dannosa per la salute. In questo senso, questa ricerca applica concetti prettamente teorici per meglio comprendere l’uso improprio di farmaci e traccia potenziali orientamenti d’adottare nell’ambito di una politica sanitaria pubblica.

Direct link to Lay Summary Last update: 29.03.2013

Responsible applicant and co-applicants

Employees

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
EHPS/DHP 2016 Poster Medication non-adherence in hypertension: the role of health literacy, empowerment and medication beliefs 01.08.2016 Aberdeen, Great Britain and Northern Ireland Nakamoto Kent; Nafradi Lilla; Galimberti Elisa; Schulz Peter;
Third Convention of DGPuK’s Ad-Hoc Group in Health Communication, Lugano, Switzerland, November 2015. Talk given at a conference How can patient resilience be improved through doctor-patient relationship and communication? 06.11.2015 Lugano, Switzerland Galimberti Elisa; Nakamoto Kent; Nafradi Lilla; Schulz Peter;
13th International Conference on Communication in Healthcare (ICCH) Talk given at a conference The (side) effects of patient empowerment on medication adherence: a systematic review. 09.10.2015 New Orleans, United States of America Nakamoto Kent; Schulz Peter; Nafradi Lilla;
International Communication Association Talk given at a conference Message Framing Tailored to the Patients’ Regulatory Focus as a Tool to Promote Medication Adherence 04.05.2015 San Joan, Puerto Rico Schulz Peter; Nafradi Lilla;
European Association for Communication in Healthcare (EACH) Talk given at a conference Examining the relationship between empowerment and adherence to therapeutic regimen: Potential pitfalls of patient-centeredness? 06.10.2014 Heidelberg, Germany Schulz Peter; Nafradi Lilla;
COMET - Conference on Communication, Medicine and Ethics Talk given at a conference Qualitative Approach to The Role of Medication Literacy and Empowerment in Non-Adherence to Prescription Drug Regimens 02.06.2014 Lugano, Switzerland Schulz Peter; Nafradi Lilla; Nakamoto Kent;


Associated projects

Number Title Start Funding scheme
135114 Guided Health Literacy and Empowerment: The Role of Social Interaction 01.06.2011 ProDoc
153526 More Informed, More Involved: The Roles of Psychological Empowerment and Health Literacy for Older Patients’ Participation in Health Care. 01.07.2014 Project funding (Div. I-III)

Abstract

Non-adherence to prescription medication regimens is recognized as a serious medical problem. Across a number of medical conditions including hypertension and cardio-vascular disease, dia-betes, HIV, and chronic pain, the prevalence of non-adherence to physician instructions regarding the use of medications has been shown to range from 15% up to well over 50%. The literature on non-adherence, however, is somewhat fragmented in that studies focus on one medical condition. In addition, the studies often provide only partial theoretical explanations for the phenomenon. In this project, we seek to provide a broader theoretical framework for examining the problem of medication non-adherence and to test it relative to two quite different medical conditions-hypertension and chronic non-malignant pain.In prior work supported by the SNF, the applicants have developed and begun to test a model of health literacy and patient empowerment that may shed new light on the problem of medication non-adherence. Ideally, of course, literacy and empowerment will join to enable the patient or healthcare consumer to make informed and constructive health choices that will advance his or her health outcomes and quality-of-life. However, the framework suggests and our preliminary data suggest that the case of low health literacy and high psychological empowerment can lead the patient to make choices that place the patient in danger of making poor choices.In order to examine this problem, we propose a multi-method approach involving three studies. In the first study, qualitative depth interviews of patients suffering from either hypertension or from chronic non-malignant pain will be conducted to elucidate the patients’ understanding of their condition, the medications that have been prescribed (benefits and potential side effects), their feelings about the medication and its use, and any “mythologies” they may have regarding the medication. In the second study, we seek to specify the relationships between the issues uncovered in Study 1 and medication regimen adherence and quality-of-life. The study will involve a survey of 200 patients being treated by a physician for hypertension and 200 being treated for chronic pain. In Study 3, we seek to build on the relationships identified in Study 2 to develop interventions to improve health literacy and health empowerment, and test their impact and interaction in improving medication adherence.The planned study will be the first to test the applicants' framework of health empowerment and its effects which also involves an expansion of the concept of health literacy from a narrow functional understanding to a more comprehensive concept of wider utility. The study will deepen our understanding of the antecedents of non-compliance with medication therapy prescribed by a physician. The goal is to address an important problem with a high potential for health damage and one that is highly relevant to the study area, Canton Ticino, and the specific medical conditions of high blood pressure and pain. Most decisively, the study opens up new approaches to studying the causes of medication non-compliance incorporating contemporary, theoretically grounded concepts with a view to informing health policy and improving health practice.
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