Consumers' willingness to use a medication management service: The effect of medication-related worry and the social influence of the general practitioner

Background Some consumers at risk of experiencing medication-related problems have chosen not to use pharmacist-provided medication management services. Previous research has shown that consumers' willingness to use the Australian Home Medicines Review (HMR) service depends on the extent to which they believe that they will receive medication information to assist them with self-management. Objectives The aim of this study was to develop and test a model of willingness to use HMR among consumers who were eligible to receive the service but have not yet experienced it. Specifically, this study aimed to determine the effects of consumers' medication-related worry and the social influence of the consumer's general practitioner (GP) over willingness. Methods A cross-sectional postal survey was conducted among 1600 members of Council on the Ageing (NSW, Australia). Respondents were included in the study if they had not experienced an HMR and were taking more than 5 medicines daily or more than 12 doses daily. Measurement scales were developed or were based on previous research. Confirmatory factor analysis was used to test the reliability and validity of the multi-item scales. Multiple regression analysis and structural equation modeling (SEM) were used to test the model. Results Surveys received from 390 respondents (24.3%) were analyzed. Respondents held overall low-to-neutral positive outcome expectancy (POE). The SEM analysis revealed that worry had a direct effect on POE (ß = 0.35, P < .05) and an indirect effect on willingness (ß = 0.22, P < .05). Subjective norms had a direct effect on willingness (ß = 0.27, P < .05) but not POE. Worry was higher among those who had experienced a change in the medication regimen within the past 3 months (ß = 0.19, P < .001). Conclusions Those consumers who were worried about their medicines were more willing to use HMR. The consumer's GP appeared to exert a significant positive social influence over willingness to use