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Cue-responding behaviors during pharmacy counseling sessions with patients with asthma about inhaled corticosteroids: Potential relations with medication beliefs and self-reported adherence.

Driesenaar, J.A., Smet, P.A.G.M. de, Hulten, R. van, Noordman, J., Dulmen, A.M. van. Cue-responding behaviors during pharmacy counseling sessions with patients with asthma about inhaled corticosteroids: Potential relations with medication beliefs and self-reported adherence. Health Communication: 2016, 31(10), p. 1266-1275.
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The aim of this study was to examine cue-responding behavior at the pharmacy while counseling about inhaled corticosteroids (ICS) in relation to medication adherence and medication beliefs. Patients with asthma aged ≥18 years using ICS were recruited from 12 pharmacies. Counseling sessions were video-recorded. Patients' emotional and informational cues and pharmacists' and pharmacy technicians' cue-responding behaviors were coded using an expanded version of the Medical Interview Aural Rating Scale. The Beliefs about Medicines Questionnaire assessed patients' ICS concern and necessity beliefs. Self-reported ICS adherence was measured by four questions. During the 86 sessions, patients expressed on average 2.3, mostly informational, cues (70.8%). In 26.7% of the sessions, no cues were expressed. Pharmacists' and technicians' responses to emotional cues (59.3%) were mostly inadequate, and to informational cues mostly appropriate (63.6%). Providing inappropriate information (20.3%) was related to higher concerns post session (p < .05), and cue exploration to higher self-reported adherence at 3 months (p < .05). Apparently, providers' responses to patients' cues might have therapeutic value. In addition, patients might need to be encouraged to ask questions and express their concerns.