Background Non-Compliance with Long term medication is reported as high 60% (1). Health belief model suggests four elements contribute to this problem. The Beliefs About Medicines Questionnaire (BMQ) is a tool for evaluating people's beliefs about medicines (1).

Objectives A Service Evaluation of compliance with prescribed medication for Long Term Rheumatologic Conditions at Central Middlesex Hospital. This was conducted to assess any possible relationship between compliance with medicines and beliefs or concerns or patient's ethnicity.

Methods The design was a voluntary self-reported, cross-sectional paper based questionnaire survey of people with Rheumatic Conditions. Twelve questions were grouped within three categories (healthcare utilisation, necessity beliefs and concern beliefs) to capture compliance behaviour for later analysis and comparison.

The Beliefs about Medicines Questionnaire was adapted from ref (1) to distinguish patients beliefs of 'necessity' or 'concerns'. In line with principles of PPP, the questionnaire was discussed prior to the audit with a sample focus group of 5 patients who contributed to the wording and the simplification of the questions re: ethnicity.

Questionnaires were offered to all patients attending the CMH Rheumatology Unit. The evaluation was discontinued when a target of 100 was reached ( n=102). No questionnaires were excluded. And upto 5% of questions were unanswered. Data was analysed on SPSS.

Results The Number of questionnaires returned for this service evaluation was 102.

• Most respondents (94%) showed compliance with rheumatic medication as prescribed.

• More than half the respondents (66%) agreed or strongly agreed that their arthritis medications are necessary for their health.

• 54% were concerned about potential adverse consequences.

• The overall necessity score (19.32 S.D. 3.17) was higher than the concerns score (13.48; S.D. 3.35; t =61.57, P<0.001).

• Concerns about the long term effect of rheumatic conditions correlate positively with perceptions of health in the future P<0.01 level (2-tailed Pearson).

• No significant correlation was found between compliance and patient's ethnicity/individuals demographics.

Conclusions Most people with Rheumatic conditions have positive beliefs about the necessity of their medication. However, levels of concern are high, especially towards the long-term effects of the medication. This concurs with asimilar study in Rheumatoid Arthritis.(2). The service evaluation using the Beliefs about Medicines Questionnaire has helped to identify people at risk of poor compliance long term. This illustrates a need to discuss patients beliefs and concerns in targeted drug counseling sessions with specialist nurses. A post study patient focus group recognised the high level of compliance yet recommended a fixed weekly walk in session with a nurse and pharmacist to sustain this high quality outcome. Further methods of continued patient re-education will be explored.

References

1. Horne R, Weinman J, Hankins M. The Beliefs about Medicines Questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health 1999;14:1–24.

2. Neame R, Hammond A Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis. Rheumatology (Oxford) 2005;44:762–7.

References

Disclosure of Interest None declared