Medication-related beliefs, for example, beliefs that medicines are unnecessary or that side effects are likely, can influence medication behaviors and experiences, potentially impacting quality of life and mortality. At times, it may be useful to change medication-related beliefs, for example, to reduce patients' concerns about side effects when extensive evidence suggests side effects are rare. Currently we do not know the most effective methods to address medication beliefs. Systematic review and meta-analysis of randomized controlled trials that measured medication-related beliefs in people prescribed medication for long-term condition(s). We extracted data on behavior change techniques (BCTs), belief measure, study and patient characteristics, risk of bias, and quality of description. We identified 56 trials randomizing 8,714 participants. In meta-analysis, interventions led to small-to-medium effects (n = 36, Hedges' g = .362, 95% confidence interval [CI] [.20, .52], p < .001) in increasing beliefs about medication need/benefit and reducing concerns about medication (n = 21, Hedges' g = -.435, 95% CI [-0.72, -0.15], p < .01). Effect sizes were higher for interventions that reported a significant effect on adherence. Problem solving, information about health consequences, and social support (unspecified) were the most prevalent BCTs. Fourteen BCTs were associated with significant effects on need/benefit beliefs and four BCTs were associated with significant effects on concern beliefs. It is possible to modify medication-related beliefs using a range of interventions and techniques. Future research should explore the best ways to operationalize these BCTs for specific health conditions to support medication beliefs and improve adherence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Community pharmacies are well placed to provide public-health interventions within primary care settings. This study aimed to establish the general public’s perceptions of community pharmacy-based public-health services in the UK by designing a structured questionnaire to assess the barriers and facilitators to optimizing this role. Methods: A standardized questionnaire was developed informed by the literature, additional semi-structured interviews, and synthesis of key findings with the authors’ previous research based on data generated from eight focus groups. The original 42-item questionnaire was distributed online from May to June 2021 via social media platforms to capture the views of non-regular pharmacy users. Following exploratory factor analysis, and Cronbach’s alpha analysis, total Likert scale response scores were calculated. Results: Of the 306 responders, 76.8% were female with a mean age of 34.5 years (SD = 15.09). The most prevalent pharmacy use reported was 1–2 times a year (28.1%). Exploratory factor analysis revealed four scales: Expertise, Role in Public Health, Privacy, and Relationship (18 items) with acceptable internal consistency and good face and content validity. Awareness of well-established pharmacy services was high; however, responders demonstrated poor awareness of public-health-related services and low recognition of pharmacy expertise for this role. A lack of an established relationship with community pharmacies and privacy concerns were also perceived barriers. Conclusions: Based on these findings, considerable effort is needed to increase public awareness and address these concerns if strategic plans to utilize community pharmacy in the delivery of public-health policy are to be successful. The PubPharmQ provides a novel, structured questionnaire to measure the public’s perceptions of community pharmacy’s role in public health.

Objectives: Inhalers containing hydrofluorocarbons have significant global warming potential. This project aimed to understand patient and community pharmacy (CP) staff perspectives on engaging in a CP-based inhaler recycling scheme. Methods: The COM-B Model of Behaviour and the Theoretical Domains Framework (TDF) underpinned the qualitative data collection methodology. Data from eleven patients and five CP staff were mapped to the COM-B, TDF, and Behaviour Change Wheel. Results: Patients and CP staff believed widespread knowledge of the need for, and existence of inhaler recycling schemes would encourage participation, building on existing recycling behaviours and aligning with moral obligations. Patients viewed CPs as trusted information sources, well-placed to raise recycling awareness. No patient participants recycled their inhalers and they felt that CPs were not adequately promoting recycling. Despite being involved in a pilot scheme, CP staff described having insufficient time with patients to encourage recycling. Patients saw inhaler recycling as integral to the CP’s professional role whereas CP staff felt this responsibility was for the wider healthcare team. Both groups agreed inhaler recycling awareness should be raised, highlighted the busyness of CPs as a barrier to conversations, and considered feedback on the inhaler recycling pilots success an important motivator. Conclusions: This study provides new insights into patient’ and CP staff views on inhaler disposal. Whilst some barriers and facilitators were the same for both, identified areas of divergence surrounded the TDF Domain Professional Role and Identity. Further research should quantify the extent to which the wider population and CPs in Wales hold these views.

Parkinson's disease (PD) is a progressive neurodegenerative disease which primarily presents with the core symptoms of rigidity, postural instability, tremor, and bradykinesia. Non-adherence to prescribed PD treatments can have significant ramifications, such as poor symptom control and greater disease burden. Reasons for poor adherence are multifaceted, particularly when medication regimens are complex and often based on perceptual and practical barriers. Additionally, engaging fully non-adherent patients in research is challenging since they may have dropped out of service provision, yet their contribution is vital to fully understand the rationale for non-adherence. This paper aims to present a case study on the perspectives of one person with PD, a participant in a previously published qualitative study investigating the barriers and facilitators to medication adherence in PD. In this paper, the participant's diagnostic journey is described, and experiences of medical consultations are summarised to explain their reasons for not adhering to any of the standard UK PD treatments prescribed. The participant's preferences for using Vitamin B1 (thiamine) injections to manage the symptoms are reported and the rationale for doing so is discussed. We consider the case through the lens of a behavioural science approach, drawing on health psychology theory, the Theoretical Domains Framework (TDF), to inform the review and the practical challenges faced when analysing the data for this participant. Implications for pharmacy practice, in particular, are also put forward with view to ensuring that patients such as Mr. Wilkinson are provided with the opportunity to discuss treatment choices and self-management of long-term conditions such as PD. We also discuss the importance of reaching under-represented members of the population in medication adherence research, which embraces the principles of equality, diversity, and inclusion in research.

Pharmacy professionals are well-placed to provide medication adherence support to patients. The Capability, Opportunity, Motivation-Behaviour (COM-B) and Theoretical Domains Framework (TDF) are two complementary models previously applied to medication-taking behaviour. Understanding the patient-specific barriers and facilitators to adherence using psychological frameworks from the early stages of pharmacy education enables the design and delivery of effective interventions. To examine whether a novel 'mock medicine' learning activity enabled students to experience the range of barriers and facilitators to medication adherence using the COM-B and TDF. A mock medicine activity was conducted with students at pharmacy schools in three universities in the UK, Norway, and Australia over one week. Percentage adherence was calculated for five dosing regimens; theoretical framework analysis was applied to map reflective statements from student logs to COM-B and TDF. A total of 349 students (52.6%) returned completed logs, with high overall mean adherence (83.5%, range 0-100%). Analysis of the 277 (79.4%) students who provided reflective statements included barriers and facilitators that mapped onto one (9%), two (29%) or all three (62%) of the COM-B components and all fourteen TDF domains (overall mean = 4.04; Uni 1 = 3.72; Uni 2 = 4.50; Uni 3 = 4.38; range 1-8). Most frequently mapped domains were 'Environmental context and resources' (n = 199; 72%), 'Skills' (n = 186; 67%), 'Memory, attention and decision-making' (184; 66%) and 'Beliefs about capabilities' (n = 175; 63%). This is the first study to utilise both COM-B and TDF to analyse a proxy measure of medication adherence in pharmacy education. Data mapping demonstrated that students experienced similar issues to patients when prescribed a short course of medication. Importantly, all the factors influencing medication-taking reported by students were captured by these two psychological frameworks. Future educational strategies will involve students in the mapping exercise to gain hands-on experience of using these psychological constructs in practice.