Improving the patient medication experience is a key factor in improving patient medication adherence, and it is also necessary to improve patient outcomes and medical safety. At present, there is a lack of measurement tools for the primary medication experience of patients with chronic diseases in China, which seriously restricts the research and practice of pharmaceutical service and management in primary medical institutions.

The purpose of this study was to develop the Primary Medication Experience Scale for Chronic Disease Patients, which is applicable to the practice of chronic disease management in China, and to conduct reliability and validity tests, with the aim of providing instrumental support for research and practice of health management for chronic disease patients.

This study used a combination of qualitative and quantitative methods to develop the scale. First, a pool of scale items was generated through the literature review method, and a preliminary primary medication experience scale for patients with chronic diseases was formed through the semi-structured interview method and under the guidance of the perceived value theory. Through the Delphi expert consultation method, the preliminary primary medication experience scale for patients with chronic diseases was consulted and validated, and revised and improved. In October 2023, a random sampling method was used in primary healthcare institutions in Shandong Province to select chronic disease patients attending primary healthcare institutions for on-site research, to debug the scale in terms of language and culture and to test the reliability and validity of the scale, and to make further optimization and adjustment of the scale, to finally form the Scale of Experience of Primary Medication Use for Chronic Disease Patients.

Through literature analysis, 14 dimensions related to medication experience were extracted. A preliminary scale item pool comprising 8 dimensions and 40 items was constructed through semi-structured interviews. The scale was modified and refined using the Delphi expert consultation method. The expert response rates in two rounds were 95% and 100%, respectively, with mean expert authority coefficients of 0.86 and 0.88, respectively. The experts provided scientifically sound and authoritative suggestions and recommendations for revisions, resulting in a scale containing 7 dimensions and 29 items. Through field investigation, the reliability and validity testing results of the scale were satisfactory. The critical ratio analysis of scale items showed that all P values were <0.05. Cronbach's α coefficients for the total scale and all dimensions were >0.800, split-half reliability coefficients were all >0.700, and intraclass correlation coefficients (ICC) were all >0.800. After rotation, all item factor loadings were >0.500. The confirmatory factor analysis model fit indices were: chi-square to degrees of freedom ratio (CMIN/DF) = 1.485, goodness-of-fit index (GFI) = 0.902, root mean square error of approximation (RMSEA) = 0.039, root mean square residual (RMR) = 0.03, comparative fit index (CFI) = 0.981, normed fit index (NFI) = 0.945, incremental fit index (IFI) = 0.981. The composite reliability (CR) values were all >0.7, and average variance extracted (AVE) values were all >0.500. Ultimately, a primary care medication experience scale for patients with chronic diseases was developed, comprising 3 first-level dimensions (functional value, emotional value, and social value), 7 second-level dimensions, and 28 measurement items.

The primary medication experience scale for chronic disease patients developed in this study has good reliability and validity, has certain local appropriateness and scientific validity, and can be used in the survey research of primary medication experience for chronic disease patients.