Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Measuring the Impact of Patient Educational Materials about Medications in Meeting Patient Needs: Development and Validation of the Medication Education Impact Questionnaire (MeiQ).
Ciciriello3, Sabina, Buchbinder1, Rachelle, Wicks4, Ian, Osborne2, Richard H.
Patient education is essential for patients to participate in decision-making and self-management. Evaluation of new educational interventions should incorporate outcomes that are relevant to patients as well as healthcare professionals. At present there are no measures that adequately evaluate the impact of education in meeting patient needs. The objectives of this study were to: (i) To determine the perceived needs of patients when starting a new medication; (ii) to develop a questionnaire assessing the impact of education about medications in meeting patient needs, facilitating shared decision-making and self-management and (iii) to validate this questionnaire within the target population.
Patients perceived needs when starting a new medication were explored in concept mapping workshops with patients (N=24). Quantitative and qualitative analyses were used to identify and define distinct areas of need (constructs). 130 questions were drafted to capture these needs and administered to 653 patients taking various medications for their rheumatic conditions. Exploratory and confirmatory factor analyses (CFA) were undertaken to create a robust questionnaire. A refined set of 29 questions divided into 6 scales, each measuring a patient need, were administered to 876 patients and a further CFA validation step was undertaken. To assess test-retest reliability, 200 respondents were sent a second copy of the MeiQ two weeks later (response rate of 90%).
Four key independent areas of need were identified for patients starting a new medication: The need for quality information; the ability to participate in decision-making; coming to terms with their diagnosis and treatment; and the ability to self-manage. Statistical analyses revealed that some of the subheadings within the constructs worked best as separate scales: self-management as 3 scales measuring role & responsibility, capacity and support to self-manage. Decision-making as 2 scales: active communication and informed decision-making. All questions within the scales were strongly congruent with their underlying construct. No items had substantial associations with other constructs (cross-loadings), and CFA fit indices supported the hypothesized factor model. The refined MeiQ consisted of 29 questions across 6 scales; Perception of information quality, Ability to communicate with health professionals, Coming to terms with diagnosis and treatment, Self-management role and responsibility, Self-management capacity, and Self-management support. The final scales were found to be valid, reliable (Cronbach alpha >= 0.7) and stable over time (ICC 0.68 to 0.87).
The MeiQ was developed using advanced psychometric processes and found to be a robust, multidimensional questionnaire which incorporates the patient's perspective. The MeiQ is generic and can therefore be used to evaluate education about any medication. It is likely to fill an important gap in the evaluation of educational interventions about medications.
To cite this abstract, please use the following information:
Ciciriello, Sabina, Buchbinder, Rachelle, Wicks, Ian, Osborne, Richard H.; Measuring the Impact of Patient Educational Materials about Medications in Meeting Patient Needs: Development and Validation of the Medication Education Impact Questionnaire (MeiQ). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1001