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Published in: Advances in Therapy 10/2016

Open Access 01-10-2016 | Original Research

Patients’ Perspective of Medication Adherence in Chronic Conditions: A Qualitative Study

Authors: Neus Pagès-Puigdemont, Maria Antònia Mangues, Montserrat Masip, Giovanna Gabriele, Laura Fernández-Maldonado, Sergi Blancafort, Laura Tuneu

Published in: Advances in Therapy | Issue 10/2016

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Abstract

Introduction

About 50% of patients do not take their long-term therapy for chronic conditions as prescribed. Many studies have centered on patients’ adherence to a specific treatment or single conditions, but few have taken all chronic conditions into consideration from a patient’s perspective. This study aims to explore factors that impact on drug compliance and to identify strategies to improve this from the perspective of patients with at least one chronic condition.

Methods

Patients were recruited by healthcare professionals from a hospital pharmacy, four community pharmacies, patient associations, and a primary care center in Barcelona. Five focus groups were conducted (N = 36). Conversations were audiotaped and transcribed verbatim to allow qualitative analysis.

Results

Study subjects were aged 39–90 years (mean 65 years) and the mean number of comorbidities per patient was 2.3 (range 1–7). The main modifiers of therapeutic conduct were: patients’ health beliefs, patient–prescriber relationships, and patients’ motivation and perception of illness control. Study participants wanted greater participation in decision-making concerning their health and increased education about their illness and medication. They also wanted individualized healthcare that took their preferences and personal and emotional issues into account.

Conclusion

Our results highlight how the patient–prescriber’s relationship and factors such as health beliefs, motivation and perception of illness control impact on medication adherence in chronic patients. Future interventions to optimize adherence to treatment should focus on shared decision-making and more extensive health education.

Funding

Celgene Corporation.
Appendix
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Literature
7.
10.
go back to reference Fung V, Sinclair F, Wang H, Dailey D, Hsu J, Shaber R. Patients’ perspectives on nonadherence to statin therapy: a focus-group study. Perm J. 2010;14(1):4–10.CrossRefPubMed Fung V, Sinclair F, Wang H, Dailey D, Hsu J, Shaber R. Patients’ perspectives on nonadherence to statin therapy: a focus-group study. Perm J. 2010;14(1):4–10.CrossRefPubMed
12.
13.
14.
go back to reference Mishra SI, Gioia D, Childress S, Barnet B, Webster RL. Adherence to medication regimens among low-income patients with multiple comorbid chronic conditions. Health Soc Work. 2011;36(4):249–58.CrossRefPubMedPubMedCentral Mishra SI, Gioia D, Childress S, Barnet B, Webster RL. Adherence to medication regimens among low-income patients with multiple comorbid chronic conditions. Health Soc Work. 2011;36(4):249–58.CrossRefPubMedPubMedCentral
15.
go back to reference Laba T-L, Lehnbom E, Brien J-A, Jan S. Understanding if, how and why non-adherent decisions are made in an Australian community sample: a key to sustaining medication adherence in chronic disease? Res Soc Adm Pharm. 2015;11(2):154–62. doi:10.1016/j.sapharm.2014.06.006.CrossRef Laba T-L, Lehnbom E, Brien J-A, Jan S. Understanding if, how and why non-adherent decisions are made in an Australian community sample: a key to sustaining medication adherence in chronic disease? Res Soc Adm Pharm. 2015;11(2):154–62. doi:10.​1016/​j.​sapharm.​2014.​06.​006.CrossRef
16.
go back to reference Leventhal H, Cameron L. Behavioral theories and the problem of compliance. Patient Educ Couns. 1987;10(2):117–38.CrossRef Leventhal H, Cameron L. Behavioral theories and the problem of compliance. Patient Educ Couns. 1987;10(2):117–38.CrossRef
17.
go back to reference Rosenstock IM, et al. A National Study of Health Attitudes and Behavior. Ann Arbor: The University of Michigan, School of Public Health; 1965. Rosenstock IM, et al. A National Study of Health Attitudes and Behavior. Ann Arbor: The University of Michigan, School of Public Health; 1965.
18.
go back to reference Fishbein MAI. Belief, attitude intention and behaviour: an introduction to theory and research. Menlo Park: Addison-Wesley; 1975. Fishbein MAI. Belief, attitude intention and behaviour: an introduction to theory and research. Menlo Park: Addison-Wesley; 1975.
19.
go back to reference Leventhal H, Benyamini Y, Brownlee S, et al. Illness representations: theoretical foundations. In: Petrie KJ, Weinman JA, editors. Perceptions of health and illness. Amsterdam: Harwood Academic; 1997. p. 19–45. Leventhal H, Benyamini Y, Brownlee S, et al. Illness representations: theoretical foundations. In: Petrie KJ, Weinman JA, editors. Perceptions of health and illness. Amsterdam: Harwood Academic; 1997. p. 19–45.
20.
go back to reference Mack N, Woodsong C, MacQueen KM, Guest G, Namey E. Qualitative research methods: a data collector’s field guide. Family Health International (FHI). North Carolina, USA; 2005. p. 51–2. Mack N, Woodsong C, MacQueen KM, Guest G, Namey E. Qualitative research methods: a data collector’s field guide. Family Health International (FHI). North Carolina, USA; 2005. p. 51–2.
21.
go back to reference Balbay O, Annakkaya AN, Arbak P, Bilgin C, Erbas M. Which patients are able to adhere to tuberculosis treatment? A study in a rural area in the northwest part of Turkey. Jpn J Infect Dis. 2005;58(3):152–8.PubMed Balbay O, Annakkaya AN, Arbak P, Bilgin C, Erbas M. Which patients are able to adhere to tuberculosis treatment? A study in a rural area in the northwest part of Turkey. Jpn J Infect Dis. 2005;58(3):152–8.PubMed
23.
go back to reference Fodor GJ, Kotrec M, Bacskai K, Dorner T, Lietava J, Sonkodi S, et al. Is interview a reliable method to verify the compliance with antihypertensive therapy? An international central-European study. J Hypertens. 2005;23(6):1261–6.CrossRefPubMed Fodor GJ, Kotrec M, Bacskai K, Dorner T, Lietava J, Sonkodi S, et al. Is interview a reliable method to verify the compliance with antihypertensive therapy? An international central-European study. J Hypertens. 2005;23(6):1261–6.CrossRefPubMed
24.
go back to reference Kiortsis DN, Giral P, Bruckert ETG. Factors associated with low compliance with lipid-lowering drugs in hyperlipidemic patients. J Clin Pharm Ther. 2000;25(6):445–51.CrossRefPubMed Kiortsis DN, Giral P, Bruckert ETG. Factors associated with low compliance with lipid-lowering drugs in hyperlipidemic patients. J Clin Pharm Ther. 2000;25(6):445–51.CrossRefPubMed
25.
go back to reference Lertmaharit S, Kamol-Ratankul P, Sawert H, Jittimanee S, Wangmanee S. Factors associated with compliance among tuberculosis patients in Thailand. J Med Assoc Thai. 2005;88(Suppl 4):S149–56.PubMed Lertmaharit S, Kamol-Ratankul P, Sawert H, Jittimanee S, Wangmanee S. Factors associated with compliance among tuberculosis patients in Thailand. J Med Assoc Thai. 2005;88(Suppl 4):S149–56.PubMed
26.
go back to reference Lindberg M, Ekström T, Möller MAJ. Asthma care and factors affecting medication compliance: the patient’s point of view. Int J Qual Heal Care. 2001;13(5):375–83.CrossRef Lindberg M, Ekström T, Möller MAJ. Asthma care and factors affecting medication compliance: the patient’s point of view. Int J Qual Heal Care. 2001;13(5):375–83.CrossRef
27.
go back to reference Frazier PA, Davis-Ali SH, Dahl KE. Correlates of noncompliance among renal transplant recipients. Clin Transplant. 1994;8(6):550–7.PubMed Frazier PA, Davis-Ali SH, Dahl KE. Correlates of noncompliance among renal transplant recipients. Clin Transplant. 1994;8(6):550–7.PubMed
28.
go back to reference Sung JC, Nichol MB, Venturini F, Bailey KL, McCombs JSCM. Factors affecting patient compliance with antihyperlipidemic medications in an HMO population. Am J Manag Care. 1998;4(10):1421–30.PubMed Sung JC, Nichol MB, Venturini F, Bailey KL, McCombs JSCM. Factors affecting patient compliance with antihyperlipidemic medications in an HMO population. Am J Manag Care. 1998;4(10):1421–30.PubMed
29.
go back to reference Ghods AJND. Noncompliance with immunnosuppressive medications after renal transplantation. Exp Clin Transpl. 2003;1(1):39–47. Ghods AJND. Noncompliance with immunnosuppressive medications after renal transplantation. Exp Clin Transpl. 2003;1(1):39–47.
30.
go back to reference Senior V, Marteau TM, Weinman J, Genetic Risk Assessment for FH Trial (GRAFT) Study Group. Self-reported adherence to cholesterol-lowering medication in patients with familial hypercholesterolaemia: the role of illness perceptions. Cardiovasc Drugs Ther. 2004;18(6):475–81. doi:10.1007/s10557-004-6225-z.CrossRefPubMed Senior V, Marteau TM, Weinman J, Genetic Risk Assessment for FH Trial (GRAFT) Study Group. Self-reported adherence to cholesterol-lowering medication in patients with familial hypercholesterolaemia: the role of illness perceptions. Cardiovasc Drugs Ther. 2004;18(6):475–81. doi:10.​1007/​s10557-004-6225-z.CrossRefPubMed
31.
go back to reference Chambers JA, O’Carroll RE, Hamilton B, Whittaker J, Johnston M, Sudlow C, et al. Adherence to medication in stroke survivors: a qualitative comparison of low and high adherers. Br J Health Psychol. 2011;16(3):592–609. doi:10.1348/2044-8287.002000.CrossRefPubMed Chambers JA, O’Carroll RE, Hamilton B, Whittaker J, Johnston M, Sudlow C, et al. Adherence to medication in stroke survivors: a qualitative comparison of low and high adherers. Br J Health Psychol. 2011;16(3):592–609. doi:10.​1348/​2044-8287.​002000.CrossRefPubMed
32.
go back to reference Gordon K, Smith F, Dhillon S. Effective chronic disease management: patients’ perspectives on medication-related problems. Patient Educ Couns. 2007;65(3):407–15.CrossRefPubMed Gordon K, Smith F, Dhillon S. Effective chronic disease management: patients’ perspectives on medication-related problems. Patient Educ Couns. 2007;65(3):407–15.CrossRefPubMed
34.
go back to reference Sylvia LG, Hay A, Ostacher MJ, Miklowitz DJ, Nierenberg AA, Thase ME, et al. Association between therapeutic alliance, care satisfaction, and pharmacological adherence in bipolar disorder. J Clin Psychopharmacol. 2013;33(3):343–50. doi:10.1097/JCP.0b013e3182900c6f.CrossRefPubMed Sylvia LG, Hay A, Ostacher MJ, Miklowitz DJ, Nierenberg AA, Thase ME, et al. Association between therapeutic alliance, care satisfaction, and pharmacological adherence in bipolar disorder. J Clin Psychopharmacol. 2013;33(3):343–50. doi:10.​1097/​JCP.​0b013e3182900c6f​.CrossRefPubMed
36.
go back to reference Nilsson J, Kallman M, Ostlund U, Holgersson G, Bergqvist M, Bergstrom S. The use of complementary and alternative medicine in Scandinavia. Anticancer Res Greece. 2016;36(7):3243–51. Nilsson J, Kallman M, Ostlund U, Holgersson G, Bergqvist M, Bergstrom S. The use of complementary and alternative medicine in Scandinavia. Anticancer Res Greece. 2016;36(7):3243–51.
Metadata
Title
Patients’ Perspective of Medication Adherence in Chronic Conditions: A Qualitative Study
Authors
Neus Pagès-Puigdemont
Maria Antònia Mangues
Montserrat Masip
Giovanna Gabriele
Laura Fernández-Maldonado
Sergi Blancafort
Laura Tuneu
Publication date
01-10-2016
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 10/2016
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-016-0394-6

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