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Exploring patient experiences coping with using multiple medications: a qualitative interview study

OBJECTIVE: Long-term adherence to evidence-based medications in cardiometabolic diseases remains poor, despite extensive efforts to develop and test interventions and deploy clinician performance incentives. The limited success of interventions may be due to ignored factors such as patients’ experie...

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Autores principales: Lauffenburger, Julie C, Haff, Nancy, McDonnell, Marie E, Solomon, Daniel H, Antman, Elliott M, Glynn, Robert J, Choudhry, Niteesh K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609926/
https://www.ncbi.nlm.nih.gov/pubmed/34810179
http://dx.doi.org/10.1136/bmjopen-2020-046860
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author Lauffenburger, Julie C
Haff, Nancy
McDonnell, Marie E
Solomon, Daniel H
Antman, Elliott M
Glynn, Robert J
Choudhry, Niteesh K
author_facet Lauffenburger, Julie C
Haff, Nancy
McDonnell, Marie E
Solomon, Daniel H
Antman, Elliott M
Glynn, Robert J
Choudhry, Niteesh K
author_sort Lauffenburger, Julie C
collection PubMed
description OBJECTIVE: Long-term adherence to evidence-based medications in cardiometabolic diseases remains poor, despite extensive efforts to develop and test interventions and deploy clinician performance incentives. The limited success of interventions may be due to ignored factors such as patients’ experience of medication-taking. Despite being potentially addressable by clinicians, these factors have not been sufficiently explored, which is particularly important as patients use increasing numbers of medications. The aim is to explore patient perspectives on medication-taking, medication properties that are barriers to adherence, and coping strategies for their medication regimen. DESIGN: Individual, in-person, semistructured qualitative interviews. SETTING: Urban healthcare system. PARTICIPANTS: Twenty-six adults taking ≥2 oral medications for diabetes, hypertension or hyperlipidaemia with non-adherence. Interviews were digitally recorded and transcribed. Data were analysed using developed codes to generate themes. Representative quotations were selected to illustrate themes. RESULTS: Participants’ mean age was 55 years, 46% were female and 39% were non-white. Six key themes were identified: (1) medication-taking viewed as a highly inconvenient action (that patients struggle to remember to do); (2) negative implications because of inconvenience or illness perceptions; (3) actual medication regimens can deviate substantially from prescribed regimens; (4) certain medication properties (especially size and similar appearance with others) may contribute to adherence deviations; (5) development of numerous coping strategies to overcome barriers and (6) suggestions to make medication-taking easier (including reducing drug costs, simplifying regimen or dosing frequency and creating more palatable medications). CONCLUSION: Patients with poor adherence often find taking prescription medications to be undesirable and take them differently than prescribed in part due to properties of the medications themselves and coping strategies they have developed to overcome medication-taking challenges. Interventions that reduce the inconvenience of medication use and tailor medications to individual needs may be a welcome development.
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spelling pubmed-86099262021-12-10 Exploring patient experiences coping with using multiple medications: a qualitative interview study Lauffenburger, Julie C Haff, Nancy McDonnell, Marie E Solomon, Daniel H Antman, Elliott M Glynn, Robert J Choudhry, Niteesh K BMJ Open Qualitative Research OBJECTIVE: Long-term adherence to evidence-based medications in cardiometabolic diseases remains poor, despite extensive efforts to develop and test interventions and deploy clinician performance incentives. The limited success of interventions may be due to ignored factors such as patients’ experience of medication-taking. Despite being potentially addressable by clinicians, these factors have not been sufficiently explored, which is particularly important as patients use increasing numbers of medications. The aim is to explore patient perspectives on medication-taking, medication properties that are barriers to adherence, and coping strategies for their medication regimen. DESIGN: Individual, in-person, semistructured qualitative interviews. SETTING: Urban healthcare system. PARTICIPANTS: Twenty-six adults taking ≥2 oral medications for diabetes, hypertension or hyperlipidaemia with non-adherence. Interviews were digitally recorded and transcribed. Data were analysed using developed codes to generate themes. Representative quotations were selected to illustrate themes. RESULTS: Participants’ mean age was 55 years, 46% were female and 39% were non-white. Six key themes were identified: (1) medication-taking viewed as a highly inconvenient action (that patients struggle to remember to do); (2) negative implications because of inconvenience or illness perceptions; (3) actual medication regimens can deviate substantially from prescribed regimens; (4) certain medication properties (especially size and similar appearance with others) may contribute to adherence deviations; (5) development of numerous coping strategies to overcome barriers and (6) suggestions to make medication-taking easier (including reducing drug costs, simplifying regimen or dosing frequency and creating more palatable medications). CONCLUSION: Patients with poor adherence often find taking prescription medications to be undesirable and take them differently than prescribed in part due to properties of the medications themselves and coping strategies they have developed to overcome medication-taking challenges. Interventions that reduce the inconvenience of medication use and tailor medications to individual needs may be a welcome development. BMJ Publishing Group 2021-11-22 /pmc/articles/PMC8609926/ /pubmed/34810179 http://dx.doi.org/10.1136/bmjopen-2020-046860 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Qualitative Research
Lauffenburger, Julie C
Haff, Nancy
McDonnell, Marie E
Solomon, Daniel H
Antman, Elliott M
Glynn, Robert J
Choudhry, Niteesh K
Exploring patient experiences coping with using multiple medications: a qualitative interview study
title Exploring patient experiences coping with using multiple medications: a qualitative interview study
title_full Exploring patient experiences coping with using multiple medications: a qualitative interview study
title_fullStr Exploring patient experiences coping with using multiple medications: a qualitative interview study
title_full_unstemmed Exploring patient experiences coping with using multiple medications: a qualitative interview study
title_short Exploring patient experiences coping with using multiple medications: a qualitative interview study
title_sort exploring patient experiences coping with using multiple medications: a qualitative interview study
topic Qualitative Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609926/
https://www.ncbi.nlm.nih.gov/pubmed/34810179
http://dx.doi.org/10.1136/bmjopen-2020-046860
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