Journal of American Pharmacists Association

September-October 2008, Vol. 48, No. 5 >

Research

Outcome and self-efficacy expectations for medication management of patients with diabetes: Influence of the pharmacist-patient relationship

Marcia M. Worley, PhD; Carol J. Hermansen-Kobulnicky, PhD

J Am Pharm Assoc. 2008;48:621-631. doi:10.1331/JAPhA.2008.07090

Article

References

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Abstract

Objective To examine how outcome and self-efficacy expectations for medication management and self-monitoring of patients with diabetes vary by different indicators of a pharmacist–patient relationship.

Design Cross-sectional descriptive study.

Setting United States during late 2004.

Participants 568 noninstitutionalized adults (age ≥18 years) with type 1 or type 2 diabetes who use at least one antidiabetic medication.

Intervention Self-administered mail survey.

Main outcome measures Outcome and self-efficacy expectations for medication management and self-monitoring and pharmacist–patient relationship indicators.

Results The adjusted response rate was 60.6% (568 of 937). Respondents had differing mean self-efficacy expectation scores (F = 7.82, P < 0.001) across knowing the pharmacist to varying degrees, and mean self-efficacy expectation scores were slightly higher for those who consult with a pharmacist to learn about antidiabetic medications (t = –2.41, P = 0.02) compared with those who do not. Relationship quality was correlated with both self-efficacy (r = 0.17, P < 0.000) and outcome expectation (r = 0.11, P = 0.02) scales. Self-efficacy expectations were higher for those scoring in the upper third of the pharmacist–patient relationship index compared with those in the lower third (t = –2.79, P = 0.006).

Conclusion Descriptive results support some association between the pharmacist–patient relationship and self-efficacy expectations, although whether this association lies in pharmacists providing education, social support, or both is not clear. Further research is needed to investigate this association to better elucidate the potential contribution of a pharmacist–patient relationship to patients' diabetes self-management. The pharmacist–patient relationship index developed for this study appears to provide a more comprehensive and sensitive measure compared with other indices, suggesting potential utility in future studies.

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References

Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2005.

U.S. Department of Health and Human Services. Healthy People 2010: objectives for improving health. Chapter 5: Diabetes. Accessed at www.healthypeople.gov, August 21, 2006.

Anderson RM. Is the problem of compliance all in our heads? Diabetes Educ. 1985;11:31–4.[CrossRef]

Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23:943–50.[PubMed]

Williams KE, Bond MJ. The roles of self-efficacy, outcome expectancies and social support in the self-care behaviours of diabetics. Psych Health Med. 2002;7:127–41.

Berringer R, Shibley MCH, Cary CC, et al. Outcomes of a community pharmacy-based diabetes monitoring program. J Am Pharm Assoc. 1999;39:791–7.

Jaber LA, Hapley H, Fernet M, et al. Evaluation of a pharmaceutical care model on diabetes management. Ann Pharmacother. 1996;30:238–43.[PubMed]

Cranor CE, Christensen DB. The Asheville Project: short-term outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc. 2003;43:149–59.

Clifford RM, Davis WA, Batty KT, Davis TME. Effect of a pharmaceutical care program on vascular risk factors in type 2 diabetes. Diabetes Care. 2005;28:771–6.[PubMed]

Leal S, Glover JJ, Herrier RN, Felix A. Improving quality of care in diabetes through a comprehensive pharmacist-based disease management program. Diabetes Care. 2004;27:2983–4.[PubMed]

Cranor CW, Bunting BA, Christensen DB. The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc. 2003;43:173–84.

American Pharmacists Association Foundation. Diabetes Ten City Challenge. Accessed at www.aphafoundation.org/Programs/Diabetes_Ten_City_Challenge/, June 19, 2006.

American Pharmacists Association. ABC 20/20 broadcast follow-up. Accessed at www.aphanet.org/AM/Template.cfm?Template=/CM/ContentDisplay.cfm&ContentID=7781, April 30, 2007.

Krichbaum K, Aarestad V, Buethe M. Exploring the connection between self-efficacy and effective diabetes self-management. Diabetes Educ. 2003;29:653–62.[PubMed]

Johnson JA. Self-efficacy theory as a framework for community pharmacy-based diabetes education programs. Diabetes Educ. 1996;22:237–41.[PubMed]

Bandura A. Self-efficacy: towards a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.[PubMed]

Bandura A. Self-efficacy: the exercise of control. New York: W.H. Freeman; 1997.

Godin G, Cote J, Naccache H, et al. Prediction of adherence to antiretroviral therapy: a one-year longitudinal study. AIDS Care. 2005;17:493–504.[PubMed]

DiIorio C, Shafer PO, Letz R, et al. Project EASE: a study to test a psychosocial model of epilepsy medication management. Epilepsy Behav. 2004;5:926–36.[PubMed]

Fraser C, Morgante L, Hadjimichael O, Vollmer T. A prospective study of adherence to glatiramer acetate in individuals with multiple sclerosis. J Neurosci Nurs. 2004;36:120–9.[PubMed]

Scherer YK, Bruce S. Knowledge, attitudes, and self-efficacy and compliance with medical regimen, number of emergency department visits, and hospitalizations in adults with asthma. Heart Lung. 2001;30:250–7.[PubMed]

Ven van der NCW, Weinger K, Yi J, et al. The confidence in diabetes self-care scale. Diabetes Care. 2003;26:713–8.[PubMed]

Hurley CC, Shea CA. Self-efficacy: strategy for enhancing diabetes self-care. Diabetes Educ. 1992;18:146–50.[PubMed]

McCaul KD, Glasgow RE, Schafer LC. Diabetes regimen behaviors: predicting adherence. Med Care. 1987;25:868–81.[PubMed]

Skelly AH, Marshall JR, Haughey BP, et al. Self-efficacy and confidence in outcomes as determinants of self-care practices in inner-city, African-American women with non-insulin-dependent diabetes. Diabetes Educ. 1995;21:28–46.

Sarkar U, Fisher L, Schillinger D. Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy? Diabetes Care. 2006;29:823–9.[PubMed]

Bandura A. The self-system in reciprocal determinism. Am Psychol. 1978;33:344–58.

Bandura A. Social foundations of thought and action. Englewood Cliffs, NJ: Prentice Hall; 1986.

Baranowski T, Perry CL, Parcel GS. How individuals, environments, and health behavior interact. In: Glanz K, Lewis FM, Rimer BK, Eds. Health behavior and health education. San Francisco, CA: Jossey-Bass; 2002:165–84.

Pilisuk M, Parks S. The place of networks analysis in the study of supportive social associations. Basic Appl Soc Psych. 1981;2:121–35.

Buri PS, Vathesatogkit P, Charoenpan P, et al. A clinic model for better tuberculosis treatment outcome and factors including compliance. J Med Assoc Thai. 1985;68:358–60.

Miles SH, Maat RB. A successful supervised outpatient short-course tuberculosis treatment program in an open refugee camp on the Thai-Cambodian border. Am Rev Respir Dis. 1984;130:827–30.[PubMed]

Yeager H, Medinger AE. Tuberculosis long term care beds: have we thrown the baby out with the bath water? Chest. 1986;90:732–53.

Huston TL, Burgess RL. Social exchange in developing relationships: an overview. In: Huston TL, Burgess RL, Eds. Social exchange in developing relationships. New York: Academic; 1979:3–28.

Bandura A. Self-efficacy mechanism in human agency. Am Psychol. 1982;37:122–47.

Strecher VJ, DeVellis BM, Becker MH, Rosenstock IM. The role of self-efficacy in achieving health behavior change. Health Educ Q. 1986;13:73–91.[PubMed]

Babb VJ, Babb J. Pharmacist involvement in Healthy People 2010. J Am Pharm Assoc. 2003;43:56–60.

Worley-Louis MM, Hermansen-Kobulnicky CJ. Do diabetic patients' medication use beliefs and perceived abilities vary by actual, preferred and potential sources of medication help? Poster presented at the American Pharmacists Association Annual Meeting, Seattle, WA, March 26–30, 2004.

Tresolini CP, Pew-Fetzer Task Force on Advancing Psychosocial Health Education. Health professions education and relationship-centered care. San Francisco, CA: Pew Health Professions Commission; 1994.

Emanuel EJ, Emanuel LL. Four models of the physician-patient relationship. JAMA. 1992;267:2221–6.[PubMed]

Murray E, Charles C, Gafni A. Shared decision-making in primary care: tailoring the Charles et al. model to fit the context of general practice. Patient Educ Couns. 2006;62:205–11.[PubMed]

Worley-Louis MM, Schommer JC. Pharmacists' therapeutic relationships with older adults: the impact of participative behavior and patient-centeredness on relationship quality and commitment. J Soc Adm Pharm. 2002;19:180–9.

Hermansen CJ, Wiederholt JB. Pharmacist-patient relationship development in an ambulatory clinic setting. Health Commun. 2001;13:307–25.[PubMed]

Chewning B, Boh L, Wiederholt J, et al. Does the concordance concept serve patient medication management? Int J Pharm Pract. 2001;9:71–9.

Bijl van der J, Poelgeest-Eeltink van der van A, Shortridge-Baggett L. The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. J Adv Nurs. 1999;30:352–9.[PubMed]

Worley-Louis MM, Schommer JC, Finnegan JR. Construct identification and measure development for investigating pharmacist-patient relationships. Patient Educ Couns. 2003;51:229–38.[PubMed]

Worley MM. Testing a pharmacist-patient relationship quality model among older persons with diabetes. Res Social Adm Pharm. 2006;2:1–21.[PubMed]

Dillman DA. Mail and Internet surveys: the tailored design method.2nd ed. New York: John & Wiley & Sons; 2000.

Nunnally JC, Bernstein IH. Psychometric theory.3rd ed. New York: McGraw Hill; 1994.

Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use.2nd ed. Oxford: Oxford University Press; 1995.

Perneger TV. What's wrong with Bonferroni adjustments. BMJ. 1998;316:1236–8.[PubMed]

Tabachnik BG, Fidell LS. Principal components and factor analysis. In: Using multivariate statistics.2nd ed. New York: Harper Collins; 1989;640.

Cohen J. A power primer. Psychol Bull. 1992;112:155–9.[PubMed]

Cohen J. Statistical power analysis for the behavioral sciences.Rev. ed. New York: Academic; 1977.

The Gallup Poll. Honesty/ethics in professions. Accessed at www.gallup.com/poll/1654/Honesty-Ethics-Professions.aspxpoll.gallup.com/content/default.aspx?ci=1654, August 1, 2006.

Strahan R, Gerbasi KC. Short, homogenous versions of the Marlow-Crowne social desirability scale. J Clin Psychiatry. 1972;28:191–3.

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