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Qualitative Analysis of Factors Influencing Patient Persistence and Adherence to Prescribed Overactive Bladder Medication in UK Primary Care

INTRODUCTION: Pharmacotherapy for overactive bladder (OAB) is generally associated with low rates of persistence and adherence. This study was conducted to explore the patient journey in a UK primary care setting (experiences, perceptions, attitudes, and levels of engagement and expectations) and id...

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Autores principales: Ali, Mahmood, Grogan, Sarah, Powell, Sue, Staniford, Leanne, Nazir, Jameel, Landeira, Margarita, Covernton, Patrick J. O., Jaggi, Ashley, Fatoye, Francis, Holt, Maxine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822799/
https://www.ncbi.nlm.nih.gov/pubmed/31559603
http://dx.doi.org/10.1007/s12325-019-01098-y
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author Ali, Mahmood
Grogan, Sarah
Powell, Sue
Staniford, Leanne
Nazir, Jameel
Landeira, Margarita
Covernton, Patrick J. O.
Jaggi, Ashley
Fatoye, Francis
Holt, Maxine
author_facet Ali, Mahmood
Grogan, Sarah
Powell, Sue
Staniford, Leanne
Nazir, Jameel
Landeira, Margarita
Covernton, Patrick J. O.
Jaggi, Ashley
Fatoye, Francis
Holt, Maxine
author_sort Ali, Mahmood
collection PubMed
description INTRODUCTION: Pharmacotherapy for overactive bladder (OAB) is generally associated with low rates of persistence and adherence. This study was conducted to explore the patient journey in a UK primary care setting (experiences, perceptions, attitudes, and levels of engagement and expectations) and identify self-reported reasons for patient non-adherence and/or non-persistence to medications for OAB. METHODS: This was a qualitative, non-interventional study involving one-to-one semi-structured, face-to-face or phone interviews with individuals aged 40–80 years, diagnosed with OAB, and currently taking, or having taken, either antimuscarinic or β(3)-adrenoceptor agonist medications within the last 12 months. Thematic analyses of interview transcripts identified themes surrounding the participants’ experiences with OAB. RESULTS: A total of 20 interviews were conducted (face-to-face, n = 13; telephone, n = 7). Interviews from five men and 13 women (mean age 70 years) were included in the final analysis. The most common OAB symptoms reported included urgency, frequency, incontinence and nocturia. Several key themes of factors influencing persistence and/or adherence to prescribed OAB medication were identified: patients’ attitude and condition adaptation behaviour; support with treatment; unmet efficacy/tolerability expectations; drug/condition hierarchy. Non-adherence and/or non-persistence to OAB medication was largely intentional, with patients balancing side effects against perceived clinical benefits. Perceived lack of efficacy was the primary reason for discontinuing treatment. Other factors cited included side effects of medication (either experienced or a fear of future effects), a general aversion to long-term medication taking, drug/condition hierarchy relative to other comorbidities, and limited healthcare professional (HCP) support/engagement. Patients expressed condition adaptation behaviours to help self-manage their condition. CONCLUSION: Persistence and adherence to OAB medication may be suboptimal. HCPs might be able to improve persistence and adherence by fostering realistic treatment expectations and scheduling regular medication reviews. These measures may help optimise patient care and support more adherent behaviours, thus minimising the impact of undertreated OAB on patient quality of life. FUNDING: Innovate UK and Astellas Pharma Europe Ltd (APEL). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12325-019-01098-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-68227992019-11-20 Qualitative Analysis of Factors Influencing Patient Persistence and Adherence to Prescribed Overactive Bladder Medication in UK Primary Care Ali, Mahmood Grogan, Sarah Powell, Sue Staniford, Leanne Nazir, Jameel Landeira, Margarita Covernton, Patrick J. O. Jaggi, Ashley Fatoye, Francis Holt, Maxine Adv Ther Original Research INTRODUCTION: Pharmacotherapy for overactive bladder (OAB) is generally associated with low rates of persistence and adherence. This study was conducted to explore the patient journey in a UK primary care setting (experiences, perceptions, attitudes, and levels of engagement and expectations) and identify self-reported reasons for patient non-adherence and/or non-persistence to medications for OAB. METHODS: This was a qualitative, non-interventional study involving one-to-one semi-structured, face-to-face or phone interviews with individuals aged 40–80 years, diagnosed with OAB, and currently taking, or having taken, either antimuscarinic or β(3)-adrenoceptor agonist medications within the last 12 months. Thematic analyses of interview transcripts identified themes surrounding the participants’ experiences with OAB. RESULTS: A total of 20 interviews were conducted (face-to-face, n = 13; telephone, n = 7). Interviews from five men and 13 women (mean age 70 years) were included in the final analysis. The most common OAB symptoms reported included urgency, frequency, incontinence and nocturia. Several key themes of factors influencing persistence and/or adherence to prescribed OAB medication were identified: patients’ attitude and condition adaptation behaviour; support with treatment; unmet efficacy/tolerability expectations; drug/condition hierarchy. Non-adherence and/or non-persistence to OAB medication was largely intentional, with patients balancing side effects against perceived clinical benefits. Perceived lack of efficacy was the primary reason for discontinuing treatment. Other factors cited included side effects of medication (either experienced or a fear of future effects), a general aversion to long-term medication taking, drug/condition hierarchy relative to other comorbidities, and limited healthcare professional (HCP) support/engagement. Patients expressed condition adaptation behaviours to help self-manage their condition. CONCLUSION: Persistence and adherence to OAB medication may be suboptimal. HCPs might be able to improve persistence and adherence by fostering realistic treatment expectations and scheduling regular medication reviews. These measures may help optimise patient care and support more adherent behaviours, thus minimising the impact of undertreated OAB on patient quality of life. FUNDING: Innovate UK and Astellas Pharma Europe Ltd (APEL). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12325-019-01098-y) contains supplementary material, which is available to authorized users. Springer Healthcare 2019-09-26 2019 /pmc/articles/PMC6822799/ /pubmed/31559603 http://dx.doi.org/10.1007/s12325-019-01098-y Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Ali, Mahmood
Grogan, Sarah
Powell, Sue
Staniford, Leanne
Nazir, Jameel
Landeira, Margarita
Covernton, Patrick J. O.
Jaggi, Ashley
Fatoye, Francis
Holt, Maxine
Qualitative Analysis of Factors Influencing Patient Persistence and Adherence to Prescribed Overactive Bladder Medication in UK Primary Care
title Qualitative Analysis of Factors Influencing Patient Persistence and Adherence to Prescribed Overactive Bladder Medication in UK Primary Care
title_full Qualitative Analysis of Factors Influencing Patient Persistence and Adherence to Prescribed Overactive Bladder Medication in UK Primary Care
title_fullStr Qualitative Analysis of Factors Influencing Patient Persistence and Adherence to Prescribed Overactive Bladder Medication in UK Primary Care
title_full_unstemmed Qualitative Analysis of Factors Influencing Patient Persistence and Adherence to Prescribed Overactive Bladder Medication in UK Primary Care
title_short Qualitative Analysis of Factors Influencing Patient Persistence and Adherence to Prescribed Overactive Bladder Medication in UK Primary Care
title_sort qualitative analysis of factors influencing patient persistence and adherence to prescribed overactive bladder medication in uk primary care
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822799/
https://www.ncbi.nlm.nih.gov/pubmed/31559603
http://dx.doi.org/10.1007/s12325-019-01098-y
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