Introduction

Lay beliefs about medicines¹ and their role in predicting patient adherence to treatment has been reported in the literature.² The development of valid and reliable measures to assess patients' perceptions of treatment has led to the empirical testing of this relationship. ^3,4 The growth in popularity of complimentary medicine may be partly due to a generally negative perception of modern medicines. A recent study of students of various conventional health related disciplines found that their views about medicines differed greatly depending on the course.⁵ It is hypothesized that complimentary practitioners hold more negative views about medicines than conventional practitioners. Therefore, this study aims to compare conventional and complimentary practitioners' views about traditional western medicines.

Methods

Postal questionnaires were sent to general practitioners, community practice nurses, community pharmacists, osteopaths, chiropractors, reflexologists and homeopaths. A random sample of 100 of each type of practitioner in the South East of England was selected from the respective practitioner registers. Questionnaires were also distributed to approximately 100 hospital pharmacists and nurses at Brighton Healthcare Trust and Guys & St Thomas' Hospitals. The standardised Beliefs about Medicines in General Questionnaire (BMQ-General) ³ was used to measure practitioners' beliefs about medicines and data collection took place during February and March 2001.

Results

Of the 672 postal questionnaires sent, 452 were returned (67%) and 65 hospital practitioners completed the study questionnaire (65%). An even distribution of responses was obtained from each practitioner group (approximately 11%). Complimentary practitioners had a significantly more negative perceptions of medicines in general. Responses to the BMQ-general showed that they were significantly more likely to perceive medicines as fundamentally harmful, addictive, poisons that should not be taken for long periods of time (t=-21.2, df=556, p<0.001) and to believe that doctors use too many medicines (t=-15.7, df=555, p<0.001). They were significantly less likely to attribute the benefits to medicines (t=13.9, df=553, p<0.001). Results of the ANOVA showed that GPs, Pharmacists and Nurses held similar beliefs about the potential harm, overuse and benefits of medicines, whilst homeopaths held significantly more negative views about medicines to all other complimentary practitioners.

Discussion

Patients with chronic diseases often seek alternative therapies alongside traditional western healthcare. This study shows that practitioners of complimentary medicine hold more negative views about medicines than practitioners of conventional medicine. If these negative views come across when consulting with patients they may receive conflicting messages depending on the type of practitioner visited. Although the impact of the practitioners' views on the patients' beliefs about medicines has not been researched it is anticipated that they will have some influence and may be a cause of poor adherence to prescribed medication in patients seeking alternative healthcare.

References

1. Donovan JL & Blake DR. (1992) Patient non-compliance: deviance or reasoned decision-making? Soc Sci Med, 34 (5): 507-513.

2. Horne R & Weinman J. (1999) Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic illness. J Psychosom; 47 (6) 555-567

3. Horne R, Weinman J & Hankins M. (1999) The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychology & Health, 14: 1-24

4. James D. (1999) Role of patients' perceptions of illness and treatment in Myocardial Infarction. PhD thesis, University of Brighton

5. Roche M. (1999) Health care practitioners' views about medicines. Final year project, BSc, School of Pharmacy, University of Brighton