Validation of an instrument to measure patients’ experiences of medicine use: the Living with Medicines Questionnaire

Figures & data

Table 1 Characteristics of participants completing the survey

Characteristic	Paper survey (n=507), n (%)	Online survey, (n=670), n (%)	Total sample, (N=1,177), n (%)
Gender
Female	306 (62.1)	542 (81.6)	848 (73.3)
Male	187 (37.9), n=493	122 (18.4), n=664	309 (26.7), n=1,157
Age, years
18–29	48 (9.7)	93 (13.9)	141 (12.1)
30–49	98 (19.7)	258 (38.7)	356 (30.6)
50–64	143 (28.8)	254 (38.1)	397 (34.1)
65 or over	208 (41.8), n=497	62 (9.3), n=667	270 (23.2), n=1,164
Education level
Bachelor degree or higher	148 (30.5)	301 (45.2)	449 (39.0)
College level	140 (28.8)	258 (38.7)	398 (34.5)
Secondary level	145 (29.8)	93 (14.0)	238 (20.6)
Up to primary	53 (10.9), n=486	14 (2.1), n=666	67 (5.8), n=1,152
Employment
Employed	176 (35.8)	324 (49.0)	500 (43.4)
Unemployed	74 (15.1)	182 (27.5)	256 (22.2)
Retired	241 (49.1), n=491	155 (23.4), n=661	396 (34.4), n=1,152
Ethnicity
White	408 (83.8)	613 (93.4)	1,021 (89.3)
Asian/Chinese	27 (5.5)	28 (4.3)	55 (4.8)
African/Caribbean	44 (9.0)	6 (0.9)	50 (4.4)
Mixed	8 (1.6), n=487	9 (1.4), n=656	17 (1.5), n=1,143
Number of medicines
1–4	261 (53.2)	302 (45.2)	563 (48.6)
5–8	176 (35.8)	253 (37.9)	429 (37.0)
≥9	54 (11.0), n=491	113 (16.9), n=668	167 (14.4), n=1,159
Requires assistance with using medicines
No	453 (91.5)	596 (89.4)	1,049 (90.3)
Yes*	42 (8.5), n=495	71 (10.6), n=667	113 (9.7), n=1,162
Pay for prescriptions
No	349 (71.7)	494 (72.0)	843 (72.1)
Yes	138 (28.3), n=487	188 (27.4), n=682	326 (27.9), n=1,169

Note:

* Carers included spouse/partner, relative, friends, nurse, support workers, support group.

Figure 1 Scree plot of the number of components (factors) in the Living with Medicines Questionnaire, showing two breaks at components 5 and 9, suggesting a multidimensional factor solution.

Table 2 Comparison of observed and criterion eigenvalues from parallel analysis

Component	Observed eigenvalues	Criterion eigenvalues*	Decision
1	9.962	1.4519	Accept
2	4.036	1.4163	Accept
3	2.367	1.3878	Accept
4	2.076	1.3637	Accept
5	1.976	1.3412	Accept
6	1.724	1.3242	Accept
7	1.515	1.3055	Accept
8	1.389	1.2868	Accept
9	1.152	1.2686	Reject
10a	1.110	1.2526	Reject

Notes:

* Generated randomly in 100 replications/simulations.

a Only 10 of 60 components are shown in the table.

Table 3 Pattern matrix of the 42-item, eight-factor structure of the LMQ-2

LMQ-2 subscale/items	Components
	1	2	3	4	5	6	7	8
1. Patient–doctor relationships and communication about medicines (9 items, α=0.887)
Q53. My doctor(s) listen to my opinions and concerns about my medicines	0.887	0.012	−0.123	0.062	−0.080	−0.030	0.094	−0.044
Q22. The information my doctor(s) gives me about my medicines is useful	0.846	−0.099	0.029	−0.043	0.116	−0.074	0.017	−0.003
Q42. My doctor(s) spends enough time discussing my medicines with me	0.805	0.057	0.034	−0.159	−0.075	0.087	−0.010	0.030
Q20. I am confident speaking to my doctor(s) about my medicines	0.791	0.012	0.062	−0.049	0.022	0.015	0.020	−0.176
Q57. My doctor(s) takes my concerns about side effects seriously	0.728	0.054	−0.155	0.183	−0.142	−0.037	−0.053	−0.091
Q21. I understand what my doctor(s) tell me about my medicines	0.658	0.037	0.044	−0.171	0.197	0.119	0.087	−0.082
Q50. The health professionals providing my care know enough about me and my medicines	0.592	−0.100	0.025	0.180	0.062	−0.059	−0.028	0.137
Q33. I trust the judgment of my doctor(s) in choosing medicines for me	0.542	−0.001	0.031	0.314	0.015	−0.159	−0.129	0.001
Q45. There is enough sharing of information about my medicines between the different health professionals providing my care	0.542	−0.028	0.004	0.058	0.062	−0.003	0.004	0.209
2. Interferences with daily life (8 items, α=0.838)
Q32. Taking medicines interferes with my social life	−0.009	0.849	−0.039	0.064	0.015	0.067	0.008	−0.092
Q35. Taking medicines causes me problems with daily tasks (such as work, housework)	−0.048	0.820	−0.089	0.091	0.046	−0.037	0.035	−0.047
Q60. The medicines I use have an adverse effect on the holidays I can take	−0.052	0.730	−0.012	0.177	−0.005	0.006	−0.019	−0.150
Q29. My life revolves around using my medicines	−0.120	0.698	−0.052	0.181	−0.022	−0.317	0.100	−0.143
Q37. Taking medicines affects my driving ability	0.002	0.686	−0.110	0.029	0.040	0.026	−0.122	−0.077
Q34. I have to put a lot of planning and thought into taking my medicines	0.068	0.618	0.041	−0.192	−0.044	−0.180	−0.171	0.121
Q38. I worry that I have to take several medicines at the same time	0.140	0.592	0.087	−0.059	−0.073	0.046	0.047	0.135
Q56. Changes in daily routine cause problems with my medicines	0.024	0.558	0.105	−0.214	0.070	−0.009	−0.136	0.188
3. Practicalities (7 items, α=0.708)
Q7. It is difficult to identify which medicine is which	−0.133	−0.037	0.773	−0.034	0.046	0.030	0.073	0.019
Q1. The instructions on my medicines are easy to follow	0.059	−0.163	0.683	0.139	−0.045	0.051	0.006	−0.066
Q5. I find opening the packaging of my medicines difficult	−0.048	0.002	0.640	0.017	−0.062	−0.052	0.109	−0.002
Q2. I find getting my prescriptions from the doctor difficult	0.244	−0.064	0.635	0.087	−0.163	−0.043	−0.192	−0.121
Q3. I find getting my medicines from the pharmacist difficult	−0.099	0.041	0.628	0.259	0.089	−0.165	−0.175	−0.146
Q17. I find using my medicines difficult	−0.027	0.295	0.465	−0.087	0.040	0.208	0.134	−0.019
Q8. It is easy to keep to my medicines routine	0.027	0.083	0.400	−0.049	0.009	0.221	0.011	0.116
4. Effectiveness (4 items, α=0.796)
Q18. I am satisfied with the effectiveness of my medicines	−0.066	0.037	0.161	0.698	0.102	−0.051	0.041	0.129
Q30. My medicines live up to my expectations	0.073	0.088	−0.014	0.694	−0.008	0.084	0.054	0.092
Q51. My medicines are working	0.090	−0.007	0.060	0.685	0.019	0.008	0.181	0.137
Q31. My medicines prevent my condition getting worse	0.040	0.033	0.041	0.650	−0.070	0.168	−0.137	−0.049
5. Patient–pharmacist communication about medicines (3 items, α=0.877)
Q25. The information my pharmacist gives me about my medicines is useful	0.030	0.000	−0.039	0.049	0.911	−0.026	−0.045	−0.036
Q23. I am confident speaking to my pharmacist about my medicines	0.034	0.030	−0.055	0.037	0.879	0.002	−0.041	0.027
Q24. I understand what my pharmacist tells me about my medicines	−0.012	0.014	0.008	−0.042	0.936	0.013	0.006	−0.035
6. Acceptance of medicine use (4 items, α=0.592)
Q13. Taking medicines is routine for me	−0.019	0.010	0.060	−0.114	−0.030	0.824	0.001	0.008
Q27. I accept that I have to take medicines long term	−0.011	−0.088	−0.107	0.254	−0.049	0.739	−0.130	−0.006
Q4. My medicines are important to me	−0.084	−0.232	0.097	0.083	0.053	0.494	−0.068	−0.093
Q28. My medicines allow me to live my life as I want to	0.050	0.185	−0.045	0.278	0.098	0.483	0.102	0.037
7. Autonomy/control over medicine use (4 items, α=0.625)
Q54. I can vary the dose of the medicines I take	−0.002	−0.245	−0.010	0.064	0.028	−0.092	0.763	−0.049
Q49. I can change the times I take my medicines if I want to	0.002	0.077	−0.061	−0.021	−0.128	0.086	0.752	−0.111
Q41. I can choose whether or not to take my medicines	0.034	−0.103	0.115	−0.106	0.035	−0.301	0.592	0.043
Q52. I can adapt my medicine-taking to my lifestyle	0.038	0.106	0.037	0.194	−0.004	0.050	0.592	0.029
8. Concerns about potential harm (3 items, α=0.751)
Q11. I am concerned about experiencing side effects	−0.053	−0.041	−0.051	0.040	−0.003	−0.013	−0.021	0.925
Q12. I am concerned about possible damaging long-term effects of taking medicines	−0.055	−0.120	−0.099	0.205	−0.029	−0.019	−0.080	0.902
Q40. I worry that my medicines may interact with each other	0.053	0.329	0.163	0.011	−0.068	−0.061	0.048	0.421

Notes: Extraction method: principal component analysis. Rotation method: promax with Kaiser normalization. α=Cronbach’s alpha. The numbers in bold represent substantive factor loadings (above 0.4) showing items that are adequately associated with a specific domain/subscale of the LMQ-2.

Abbreviations: LMQ, Living with Medicines Questionnaire; Q, question.

Table 4 Intercorrelations among the LMQ-2 subscales

Subscale	Doctor	Interfrnc	Practical	Effectiv	Pharm	Accept	Auto	Concern
Doctor		0.241**	0.506**	0.711*	0.616**	0.319*	−0.189*	0.201*
Interfrnc			0.502**	0.356**	0.254**	−0.032	−0.029	0.406*
Practical				0.511*	0.507**	0.256**	−0.242*	0.190*
Effectiv					0.574**	0.534*	−0.148	0.317**
Pharm						0.269*	−0.156*	0.099
Accept							−0.402**	0.127
Auto								0.100
Concern

Notes:

* P<0.05;

** P≤0.001.

Abbreviations: accept, acceptance of medicine use; auto, autonomy/control over medicine; concern, concerns about potential harm; doctor, patient–doctor relationships and communication about medicines; effectiv, effectiveness; Interfrnc, interferences with daily life; LMQ, Living with Medicines Questionnaire; pharm, patient–pharmacist communication about medicines; practical, practicalities.

Table 5 Known-groups validity of the LMQ-2

Category	Number of participants per subgroup	Total LMQ-2 score (mean ± standard deviation)
Number of medicines
1–4	267	96.3±17.5
5–8	196	101.7±17.8
≥9	69	106.2±22.0 (P<0.001)
Assisted with medicine use
No	490	99.0±18.2
Yes	44	105.5±20.2 (P=0.026)

Abbreviation: LMQ, Living with Medicines Questionnaire.