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Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD
BACKGROUND: Adherence to ADHD medication is a complex phenomenon as the decision to adhere is influenced by a range of factors. To design tailored interventions to promote adherence, it is important to understand the factors that influence adherence in the context of its three phases: initiation, im...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137499/ https://www.ncbi.nlm.nih.gov/pubmed/32032467 http://dx.doi.org/10.1111/hex.13031 |
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author | Khan, Muhammad Umair Aslani, Parisa |
author_facet | Khan, Muhammad Umair Aslani, Parisa |
author_sort | Khan, Muhammad Umair |
collection | PubMed |
description | BACKGROUND: Adherence to ADHD medication is a complex phenomenon as the decision to adhere is influenced by a range of factors. To design tailored interventions to promote adherence, it is important to understand the factors that influence adherence in the context of its three phases: initiation, implementation and discontinuation. OBJECTIVE: The objective of this study was to explore the phase‐specific factors that influence adherence to medication in adults who have a diagnosis of ADHD. METHODS: Three focus groups (FGs) were conducted with twenty adults with ADHD in different metropolitan areas of Sydney, Australia. FGs were transcribed verbatim and thematically analysed. RESULTS: Participants’ decision to initiate medication (the initiation phase) was influenced by their perceived needs (desire to improve academic and social functioning) and concerns (fear of side‐effects) about medication following a similar process as defined by the Necessity‐Concerns Framework (NCF). The balance between benefits of medication (needs) and side‐effects (concerns) continued to determine participants’ daily medication‐taking (the implementation phase) and persistence (or discontinuation) with their medication. Forgetfulness and stigma were reported as concerns negatively impacting the implementation phase, while medication cost and dependence influenced the discontinuation phase of adherence. CONCLUSIONS: Adults’ decision to initiate, continue or discontinue medication is influenced by a range of factors; some are unique to each phase while some are common across the phases. Participants balanced the needs for the medication against their concerns in determining whether to adhere to medication at each phase. It appears that the NCF has applicability when decision making about medication is explored at the three phases of adherence. |
format | Online Article Text |
id | pubmed-8137499 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81374992021-05-24 Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD Khan, Muhammad Umair Aslani, Parisa Health Expect Special Issue on Mental Health BACKGROUND: Adherence to ADHD medication is a complex phenomenon as the decision to adhere is influenced by a range of factors. To design tailored interventions to promote adherence, it is important to understand the factors that influence adherence in the context of its three phases: initiation, implementation and discontinuation. OBJECTIVE: The objective of this study was to explore the phase‐specific factors that influence adherence to medication in adults who have a diagnosis of ADHD. METHODS: Three focus groups (FGs) were conducted with twenty adults with ADHD in different metropolitan areas of Sydney, Australia. FGs were transcribed verbatim and thematically analysed. RESULTS: Participants’ decision to initiate medication (the initiation phase) was influenced by their perceived needs (desire to improve academic and social functioning) and concerns (fear of side‐effects) about medication following a similar process as defined by the Necessity‐Concerns Framework (NCF). The balance between benefits of medication (needs) and side‐effects (concerns) continued to determine participants’ daily medication‐taking (the implementation phase) and persistence (or discontinuation) with their medication. Forgetfulness and stigma were reported as concerns negatively impacting the implementation phase, while medication cost and dependence influenced the discontinuation phase of adherence. CONCLUSIONS: Adults’ decision to initiate, continue or discontinue medication is influenced by a range of factors; some are unique to each phase while some are common across the phases. Participants balanced the needs for the medication against their concerns in determining whether to adhere to medication at each phase. It appears that the NCF has applicability when decision making about medication is explored at the three phases of adherence. John Wiley and Sons Inc. 2020-02-07 2021-05 /pmc/articles/PMC8137499/ /pubmed/32032467 http://dx.doi.org/10.1111/hex.13031 Text en © 2020 The Authors Health Expectations published by John Wiley & Sons Ltd https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Special Issue on Mental Health Khan, Muhammad Umair Aslani, Parisa Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD |
title | Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD |
title_full | Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD |
title_fullStr | Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD |
title_full_unstemmed | Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD |
title_short | Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD |
title_sort | exploring factors influencing initiation, implementation and discontinuation of medications in adults with adhd |
topic | Special Issue on Mental Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137499/ https://www.ncbi.nlm.nih.gov/pubmed/32032467 http://dx.doi.org/10.1111/hex.13031 |
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