Dália Silva Marcelino

Patients' illness schemata of hypertension: the role of beliefs for the choice of treatment

The aims of this study were (1) to investigate what are the illness perceptions of hypertensive patients and their relationship with beliefs about specific medicines, and (2) to identify different illness schemata and how they relate to the choice of medication. This was a cross-sectional study in which 191 Portuguese patients (59% females), with a hypertension diagnosis, aged over 18 years old, were recruited from a hospital clinic in the Lisbon Metropolitan area. The questionnaire included measures of choice of medication, beliefs about specific medicines (BMQ-Specific), illness perception (Brief-IPQ), and socio-demographic information. The results indicated that the components of the illness perceptions were associated with patients’ beliefs about necessity and concerns about medication. Patients seem to differ in their choice of medication (generic or brand names) according to the three illness schemata identified. Patients with more negative illness schemata were more likely to choose a brand medicine, whereas patients with a more positive perception of hypertension were more likely to choose a generic medicine. Our findings support the argument that illness perceptions and beliefs about medicines play a role in influencing patients’ preferences of medicines for the treatment of hypertension.

Assessing lay beliefs about generic medicines: Development of the generic medicines scale.

The aims of this study were to develop a scale to assess lay beliefs about generic medicines, and to investigate whether these beliefs differ according to demographic factors in an opportunistic general public sample. In the pilot study, the participants were 92 men and 136 women, and in the main study there were 314 men and 505 women. At both stages, the participants completed a questionnaire measuring beliefs about generic medicines, preference for medicines and demographic information. The scale has good face validity, showing a satisfactory level of internal consistency. An exploratory principal component analysis revealed a two-factor structure concerning beliefs about generic medicines, comprising two core themes (efficacy and similarity to brand medicines), in two different samples. Older participants showed a stronger belief in similarity with brand names than the younger group. Higher educated participants showed a stronger belief in the efficacy of generics. The opportunity to assess beliefs about generic medicines may have implications for adherence, for the implementation of health policies and for decision making about medicines.

Lay views about medicines: The influence of the illness label for the use of generic versus brand

The aim of this cross-sectional study was to investigate how different types of prescriptions using different illness labels may influence lay views about the use of generic or brand medicines. The participants were 882 Portuguese (both sexes) recruited from the general population, who completed a self-administered questionnaire. A vignette methodology was used in which different prescriptions (generic versus brand) were given for the same label (flu, hypertension, asthma and angina pectoris). The dependent variables were for each illness label: (a) the level of agreement with the prescription, (b) beliefs about the efficacy of a medicine and (c) beliefs about the relief of symptoms. There were main effects of the label and the type of prescription upon beliefs about the use of medicines. There were interactions between illness label and type of medicines. Labels which were perceived as more serious were associated with a lower belief in generic medicines. These results raise important questions concerning the need to consider illness perceptions of lay people (including perceived severity) and its relationship with perceptions of treatment for different conditions. Furthermore, these results may have implications for health-related behaviour in general, and in particular for communication between lay people and health professionals, prescribing behaviour, health costs and adherence to treatment.