Impact of self-efficacy, patient knowledge, and pharmacist interaction on adherence to oral contraceptives based on the Morisky Medication Adherence Scale (MMAS-8)

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Objective: The study aimed to: (1) explore the relationship between oral contraceptive (OC) use and adherence, participant knowledge (both perceived and measured), self-efficacy, and pharmacist interaction and (2) describe patient information-seeking preferences. Methods: This cross-sectional research study recruited a random sample of female college students to participate in an online survey. Medication adherence was based on the 8-item Morisky Medication Adherence Scale (MMAS-8). Self-efficacy, perceived knowledge, and information-seeking preferences were based on participant reports. Measured knowledge was based on correct answers to a series of challenge questions. Analyses included ANOVA and chi-square tests, bivariate correlations, and hierarchical linear regression. Results: Of the 5,000 invited female college students, 1,623 consented to participate. Those reporting use of OCs (n = 670) responded to items regarding OC knowledge, self-efficacy, and medication adherence. Among OC users, 259 (43.8%) met criteria for low adherence, 215 (36.6%) for medium adherence, and 118 (19.9%) for high adherence. Those in the high adherence group had significantly higher self-efficacy (P <0.001), perceived knowledge (P <0.001), and actual knowledge (P = 0.04). After controlling for other factors, self-efficacy (β = 0.37), perceived knowledge (β = 0.09), and use of emergency contraceptives (β = –0.16) were associated with adherence. Few participants reported discussing OCs with pharmacists (28.2%), seeking information from pharmacists (39.9%), and trusting pharmacists to best provide accurate information (16%). Conclusions: Self-efficacy and knowledge were associated with higher medication adherence, whereas past discussion of OC use with pharmacists was not associated with higher adherence. This suggests pharmacists may need to consider expanding their roles when working with patients using OCs. As policy changes encourage further involvement, pharmacists have the potential to become more engaged in patient care related to OC use. Efforts of pharmacists to improve patient self-efficacy and knowledge in conjunction with encouraging OC users to seek support from pharmacists may help to improve the proper utilization of OCs.

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