Resisting medicines: a synthesis of qualitative studies of medicine taking

Pound, Pandora; Britten, Nicky; Morgan, Myfanwy; Yardley, Lucy; Pope, Catherine; Daker‐White, Gavin; Campbell, Rona

doi:10.1016/j.socscimed.2004.11.063

Cited by 753 publications

(795 citation statements)

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“…Increased distress and low patient satisfaction with care and therapy are associated with nonadherence in psoriasis10 and we found that individual's beliefs about psoriasis and its medication also play an important role in medication adherence. Complex adherence challenges and strategic modification of treatment regimens have been reported in other LTCs22 and this study demonstrates that similar challenges are also present in psoriasis. Nonadherence to medication may be viewed as an outcome of limited personal resources and conflicting goals, and therefore seen as a strategic and rational attempt to actively manage and limit the impact of ongoing emotional distress that results from conflicting demands and priorities.…”

Section: Discussionsupporting

confidence: 68%

Nonadherence to psoriasis medication as an outcome of limited coping resources and conflicting goals: findings from a qualitative interview study with people with psoriasis

et al. 2016

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SummaryBackgroundMedication nonadherence is known to limit the effectiveness of available therapies; however, little is known specifically about medication adherence in people with psoriasis. Medicines self‐management can feel onerous to those with dermatological conditions due to the nature of therapies prescribed and many individuals with psoriasis experience additional challenges such as physical and psychological comorbidities that place significant additional demands on individuals and may undermine adherence. Viewing nonadherence to medication as an outcome of limited personal coping resources and conflicting goals may help to explain medication nonadherence.ObjectivesTo explore individuals’ perspectives of their psoriasis, medication and its management.MethodsTwenty people with psoriasis were recruited from community samples in England and interviewed in‐depth about their perceptions of their psoriasis, medication, and adherence to medication and self‐management advice. Data were analysed using Framework Analysis.ResultsParticipants reported that adhering to recommended treatment regimens conflicted with the management of the physical and psychological demands of living with psoriasis. Medication usage was viewed as a source of unresolved emotional distress and, for some, resulted in poor self‐reported adherence, which included medication overuse, underuse and rejection of prescribed therapies. Perceived lack of engagement by clinicians with participants’ self‐management difficulties was viewed as an additional source of stress and distress.ConclusionsAdhering to medication in psoriasis can be an additional source of considerable emotional distress. We interpreted some episodes of nonadherence to psoriasis medication as rational attempts by individuals to minimize distress and to gain control over their life.

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Section: Discussionsupporting

confidence: 68%

Nonadherence to psoriasis medication as an outcome of limited coping resources and conflicting goals: findings from a qualitative interview study with people with psoriasis

et al. 2016

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“…As focused upon in our previous research (21), some patients disliked taking medicines because of fears surrounding toxicity and addiction. This is a common finding in research on analgesia in OA and medicine-taking in general (20,(26)(27)(28)(29). In the present study, regardless of whether they were skeptical about using medicines, patients were reliant upon their NSAID and took it routinely.…”

Section: Discussionmentioning

confidence: 66%

“It looks after me”: How older patients make decisions about analgesics for osteoarthritis

Milder¹,

Lipworth²,

Williams³

et al. 2011

Arthritis Care & Research

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Objective: To explore the key motivators behind selection of analgesics (non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol and complementary medications (CMs)) by patients with osteoarthritis (OA).Methods: A qualitative study, in which in-depth semi-structured interviews were conducted with 15 OA patients, recruited from four general practices in Sydney, Australia. Patients were aged 65 or above, and were currently taking, or had recently taken, an NSAID for osteoarthritis.Results: Three key themes emerged from the data: reliance, routine and pill load. Reliance: Patients were strongly reliant upon NSAIDs because they consistently satisfied their needs. By contrast, they were much less reliant upon paracetamol because of uncertainty or scepticism about its effectiveness. They were not reliant upon CMs but were willing to take them indefinitely because they were perceived as being without risk. Routine and pill load: Many patients took an NSAID, as well as CMs as part of a 'daily routine'. By contrast, patients had difficulty developing a routine around using paracetamol at the recommended maximum dose because of the implicit frequency of dosing required and an aversion to the associated 'pill load'. Conclusion:The results highlight the importance of exploring the perceptions and preferences of patients with regard to analgesics for OA. Clinician advice regarding analgesia for OA should take account of the possible reliance of the patient upon an NSAID, their medicine routines, and their potential concern about the pill load associated, in particular, with paracetamol.

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“…There was a market for cholesterol reduction, but the choices made in this market speak to continued resistance to the use of medication, as predicted by the work of Pound et al (2005) and others. O F use pharmaceuticals in the context of their own explanatory frameworks and may reject medical models.…”

Section: Discussionmentioning

confidence: 99%

“…Moreira 2010). As Abraham (2010b) In one review, Pound, Britten, Morgan et al (2005) suggest that while some accept pharmaceutical treatment, lay responses to medicine are best characterised by the concept of resistance. This may operate at conceptual and practical levels (Authors, in review).…”

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confidence: 99%

“…This may operate at conceptual and practical levels (Authors, in review). As Pound et al (2005) elaborate, people may be reluctant to take medicines for many reasons: concern about side-effects and dependency, the potential disruption of regimens to daily routine, a preference for more natural therapies, the symbolic association of medicines with illness and thus an illness identity, as well as potential stigma associated with taking medicines (see also Hansen and Hansen 2006;Norreslet, Jemec and Traulsen 2010). At a practical level Pound et al (2005) highlight the way people reportedly modify regimens, for exam as well as demurring to have prescriptions filled, not initiating or discontinuing use.…”

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confidence: 99%

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The drugs don't sell: DIY heart health and the over-the-counter statin experience

Will

Weiner

2015

Social Science & Medicine

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This paper draws on a study of over-the-counter statins to provide a critical account of literature. A low dose statin, promising to reduce cardiovascular risk, was reclassified to allow sale in pharmacies in the UK in 2004. We analysed professional and policy debates about the new product, promotional and sales information, and interviews with consumers and potential consumers conducted between 2008 and 2011, to consider the different consumer identities invoked by these diverse actors.W -responsibility for heart health through exercising the choice to purchase a drug that was effectively rationed on the NHS and medical professionals raised conc that there would be a market for the drug. By contrast, those who bought the product out and paying for different food and lifestyle products and services, including those H who either preferred to take medication on the advice of a doctor, or sought to minimize medicine use.In comparison to previous studies, our analysis builds understanding of individual consumers in a market, rather than collective action for access to drugs (or, less commonly, compensation for adverse effects). Where some theories of pharmaceuticalisation have presented consumers as creating pressure for expanding markets, our data suggests that sociologists should be cautious about assuming there will be demand for new pharmaceutical products, especially those aimed at prevention or asymptomatic conditions, even in burgeoning health markets.

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Resisting medicines: a synthesis of qualitative studies of medicine taking

Cited by 753 publications

References 55 publications

Nonadherence to psoriasis medication as an outcome of limited coping resources and conflicting goals: findings from a qualitative interview study with people with psoriasis

Nonadherence to psoriasis medication as an outcome of limited coping resources and conflicting goals: findings from a qualitative interview study with people with psoriasis

“It looks after me”: How older patients make decisions about analgesics for osteoarthritis

The drugs don't sell: DIY heart health and the over-the-counter statin experience

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