Development of tools to measure prescription quality and medication compliance in adult hypertensive patients
| dc.contributor.author | Hassan, Norul Badriah | |
| dc.date.accessioned | 2015-07-30T03:18:40Z | |
| dc.date.available | 2015-07-30T03:18:40Z | |
| dc.date.issued | 2008 | |
| dc.description.abstract | The objectives of this thesis were to develop and validate new tools to measure prescription 9uality, medication compliance, and psychosocial factors contributing to non-compliance. These tools are to be used as quality measurement from the perspectives of clinicians, pharmacists and patients. The Prescription Quality Index (PQI) was developed based on three separate surveys and piloted in 120 patients with chronic illnesses and 240 patients with hypertension. The Medication Compliance Questionnaire (MCQ), Patient Satisfaction with Health Care Questionnaire (PSHC) and Psychosocial Questionnaire (PQ) were developed and validated in two separate pilot studies of 60 hypertensive patients each. A cohort study was then conducted for six months in patients with hypertension. Prescriptions were rated retrospectively and questionnaires were self-administered by patients. Results were analyzed using SPSS version 12.0.1. The PQI displayed Cronbach's alpha of 0.60 and range of intra-rater and inter-rater reliability were 0.28 to 0.97 (average: 0.76) and 0.22 to 0.82 (average: 0.52) respectively. The Cronbach's alpha for the MCQ were 0.67 and 0.84 with test-retest values of 0.78 and 0.93. For the PSHC, the Cronbach's alpha ranged from 0.76 to 0.91 and test-retest ranged from 0.54 to 0.70. The Cronbach's alpha for the PQ ranged from 0.42 to 0.87 with testretest value of0.53 to 0.77. A total of 184. patients completed the study with seven patients lost to follow-up. Tertiary education (OR=O.ll; 95% CI:0.03 to 0.43; p=O.OOI), number of drugs (OR=l.96; 95% CI:l.46 to 2.64; p<O.OOI), duration of hypertension (OR=l.Ol; 95% CI:l.OO to 1.01; p=0.009), and patients' lifestyle (OR=0.96; 95% Cl:0.93 to 0.99; p=0.004) have been identified as significant and independent factors associated with prescription quality. Patients' tertiary education (OR=0.22; 95% CI:0.06 to 0.86; p=0.029), overall satisfaction with health care (OR=0.95; 95% CI:0.91 to 0.98; p=0.006), medication barrier (complex regime, cost, and effectiveness) (OR=0.92; 95% CI:0.86 to 0.97; p=0.006), and logistic and transportation barrier (OR=1.03; 95% CI:l.Ol to 1.05; p=0.017), were identified as independent and significant factors associated with medication non-compliance. In conclusion, this thesis has generated four new tools with moderate to good psychometric properties to be used in patient care and for clinical or epidemiological studies. Factors associated with good prescription quality were higher education, lesser number of drugs, shorter duration of hypertension and healthier lifestyle. Psychosocial predictors of medication non-compliance were patient education, patient satisfaction, medication barrier, and logistic and transportation barrier. Future studies in other disease states and populations are highly recommended. | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/953 | |
| dc.language.iso | en | en_US |
| dc.subject | Prescription quality | en_US |
| dc.subject | Hypertensive patients | en_US |
| dc.title | Development of tools to measure prescription quality and medication compliance in adult hypertensive patients | en_US |
| dc.type | Thesis | en_US |
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