A Model of Medication-Taking Behavior in Elderly Individuals With Chronic Disease

Abstract

Adherence with prescription medications among elderly patients with cardiac conditions is poor. Mechanisms underlying adherence behavior have not been fully investigated. The purpose of this study was to develop a substantive model that describes medication-taking behavior in elderly individuals with chronic diseases. The study was exploratory using grounded theory. Purposive sampling was used to recruit 19 elderly cardiac patients. Four major themes were delineated from the data to describe readiness to adhere: perceived effectiveness, perceived partnership, perceived reality, and interpersonal influences. To convert perceptions into actions, 2 influencing factors, facilitating and inhibiting factors, played pivotal roles. This model could provide a useful framework for health professionals to design valid interventions for elderly patients to increase medication adherence.

Validation of an instrument to measure patients’ experiences of medicine use: the Living with Medicines Questionnaire

“…Perceptions of efficacy and concerns about the negative effects of medicines are widely reported in the literature, with most patients weighing benefits from medicines against any associated burden, perhaps enduring inconveniences associated with their use while reluctantly accepting the need for treatment 18,30,31. Patients’ perceptions concerning the desired therapeutic outcome influence both attitudes and behaviors toward medicine 32,33.…”

“…Concerns about potential harm from side effects, long-term use and/or dependency are common 10. Relationships with health professionals supplying medicines and information sharing may influence both commitment to taking medicines and perceptions of effectiveness,31 with poor relationships and communication becoming burdensome to some individuals due to consultation styles, amount of information provided, conflicting information and lack of continuity of care 34,35. Observational research shows that overall treatment burden may be compounded by patients’ experiences of medicine use being neglected during consultations 36.…”

Surviving with lung cancer: Medication-taking and oral targeted therapy

“…Our participants recognized that they were not cancer survivors in the traditional sense 36,37 ; rather, they took active treatment for a chronic life-threatening condition. They managed issues consistent with other chronically ill patient populations, such as individuals with cancer receiving trastuzumab, 37 an intravenous therapy that targets a member of the EGFR family (HER2), persons with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) receiving chronic antiretroviral therapy 38,39 , and older adults with heart disease 23 or early stage dementia 40,41 . Our previous study of medication-taking among women with early-stage breast cancer receiving therapy with an aromatase inhibitor, anastrozole, revealed that value/importance of medication, side effect severity, and medication self-management were primary constructs in the early phase of breast cancer survivorship.…”

“…Qualitative inquiry provides unique information about medication-taking behaviors and experiences of patients with chronic disorders. 23–26 Most qualitative studies of medication-taking of patients with cancer are focused on developmental issues such as egocentrism, concrete thinking, and parental involvement among children or adolescents. 25,27 Understanding the process of medication-taking for adults with NSCLC taking oral EGFRI therapy is necessary to provide comprehensive patient-centered care and to develop and test interventions tailored to the needs of persons with NSCLC.…”

A New Taxonomy for Describing and Defining Adherence to Medications

“…'adherence') or definition meets all needs of the field [115][116][117][118][119][120][121][122][123][124][125][126][127][128]. There is thus a clear need to create an agreed set of rules [129], within which future activities can fit, to provide concise and adequate definitions and an associated conceptual framework that could serve the needs of both clinical research and medical practice [129,130].…”