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 (2003) 2008;48:621-631. doi:10.1331/JAPhA.2008.07090


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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