Medication adherence is an important part of effective therapy for gastrointestinal disease. Theory has suggested that the more involved the individual is in their care the more adherent they will be to their medication regime. However, such management is often complicated by patient psychological factors, health beliefs, self-efficacy, and lack of knowledge about medication.

In this experimental study of the impact of shared responsibility for medication use: an experiment, 60 patients from four ethnic groups were randomly assigned to three groups of 20 each: 1) routine discharge medication group, 2) formal education group, and 3) self medication and shared responsibility group.

Each patient was tested on three types of written measures three times: on admission to the study, and at the end of the first and second month after discharge. These measures included psychological variables, health beliefs, and medication knowledge. Each patient completed self reports of disease symptoms, medication adherence, and side effects during the first and second month after discharge.

The Multivariate approach to repeated measures analysis of variance was used to test how the three groups differed over time on each of the variables. The findings indicated that the self responsibility group showed greater decreases in anxiety, hostility somatization, number of medication side effects and disease symptoms, and a greater increase in knowledge than the other groups. Medication adherence and self-efficacy were not improved since self-efficacy was high to begin with and medication adherence was high in all groups at the first month follow up. The variance in medication adherence was reduced in the self responsibility group.The variance in self-efficacy was also reduced in this group but only relative to the routine medication instruction group.

The results of the study suggest that an educational intervention such as the self medication and shared responsibility intervention can be effective in the management of peptic ulcer and Crohn's disease, and might positively effect other chronic diseases.


School of Public Health

First Advisor

Jerry Lee

Second Advisor

Barbara Frye

Third Advisor

Stanley Condon

Degree Name

Doctor of Public Health (DrPH)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Crohn Disease -- therapy; Chronic Disease -- therapy; Drugs -- administration & dosage; Patient Compliance; Patient Education; Peptic Ulcer -- therapy



Page Count

xiv; 191

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives