Electronic Theses and Dissertations

Date of Award

1-1-2025

Document Type

Thesis

Degree Name

M.S. in Pharmaceutical Science

First Advisor

Marie Barnard

Second Advisor

Erin Holmes

Third Advisor

Yinan Huang

School

University of Mississippi

Relational Format

dissertation/thesis

Abstract

Background

This study examined factors influencing rheumatoid arthritis (RA) patients' willingness to seek pharmacist-led disease management, using the Integrative Model of Behavioral Prediction (IMBP). Despite evidence supporting pharmacist interventions in improving outcomes, patient engagement remains low.

Methods

A mixed-methods design was employed. Semi-structured interviews with eight RA patients identified themes aligned with IMBP constructs. These findings informed a theory-driven survey distributed electronically to 509 RA patients via Qualtrics. Quantitative analyses (descriptive statistics, factor analysis, and multiple linear regression) were conducted using IBM SPSS and AMOS.

Results

Interviews revealed 13 themes across five IMBP constructs. Facilitators included positive attitudes (trust, reassurance), self-efficacy (communication confidence), and social norms (family/peer influence). Barriers involved long wait times and privacy concerns. Survey participants were predominantly female (95.09%), Non-Hispanic White (76.23%), college-educated (48.92%), and suburban residents (50.88%). Confirmatory factor analysis demonstrated good model fit (χ²/df=2.19, CFI=0.969, RMSEA=0.048). Regression analysis showed attitudes (ꞵ=.432, p<.001), social norms (ꞵ=.337, p<.001), and self-efficacy (ꞵ=.244, p<.001) positively predicted willingness (R²=.835), while barriers had a minor negative effect (ꞵ=-.051, p=.014).

Conclusion

The IMBP framework effectively explained RA patients' willingness to consult pharmacists, with attitudes, social norms, and self-efficacy as key drivers. Age and cultural factors may moderate these relationships. To enhance engagement, interventions should combine pharmacist education, digital tools, and hybrid care models to address barriers and strengthen self-efficacy. These findings support integrating pharmacists into RA care teams while addressing systemic and perceptual challenges.

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