The Contribution of Qualitative Research to Medication Adherence

McHorney, Colleen A.

doi:10.1007/978-1-4939-2920-7_28

Cited by 6 publications

(5 citation statements)

References 122 publications

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“…As a qualitative approach is the preferred paradigm in the study of socio-cultural aspects of seeking medicine or adhering to their instructions for use, 46 the study employed an exploratory, qualitative design. Due to social distancing and other restrictions put in place to control the spread of the virus, the interviews were conducted over the telephone.…”

Section: Methodsmentioning

confidence: 99%

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

Kalam¹,

Shano²,

Afrose³

et al. 2022

PPA

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Introduction The COVID-19 pandemic is thought to have led to increased “inappropriate” or “unjustified” seeking and consumption of antibiotics by individuals in the community. However, little reference has been made to antibiotic seeking and using behaviors from the perspectives of users in Bangladesh during this health crisis. Purpose This study seeks to document how antibiotic medicines are sought and used during a complex health crisis, and, within different contexts, what are the nuanced reasons why patients may utilize these medicines sub-optimally. Methods We used an exploratory, qualitative design. Forty semi-structured telephone interviews were conducted with people diagnosed with COVID-19 (n=20), who had symptoms suggestive of COVID-19 (n=20), and who had received care at home in two cities between May and June 2021 in Bangladesh. In this study, an inductive thematic analysis was performed. Results The analysis highlighted the interlinked relationships of antibiotic seeking and consumption behaviors with the diversity of information disseminated during a health crisis. Antibiotic-seeking behaviors are related to previous experience of use, perceived severity of illness, perceived vulnerability, risk of infection, management of an “unknown” illness and anxiety, distrust of expert advice, and intrinsic agency on antimicrobial resistance (AMR). Suboptimal adherence, such as modifying treatment regimes and using medication prescribed for others, were found to be part of care strategies used when proven therapeutics were unavailable to treat COVID-19. Early cessation of therapy was found to be a rational practice to avoid side effects and unknown risks. Conclusion Based on the results, we highly recommend the take up of a pandemic specific antimicrobial stewardship (AMS) program in the community. To deliver better outcomes of AMS, incorporating users’ perspectives could be a critical strategy. Therefore, a co-produced AMS intervention that is appropriate for a specific cultural context is an essential requirement to reduce the overuse of antibiotics during the COVID-19 pandemic and beyond.

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Section: Methodsmentioning

confidence: 99%

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

Kalam¹,

Shano²,

Afrose³

et al. 2022

PPA

View full text Add to dashboard Cite

show abstract

“…Qualitative research also allows for the identification of additional variables that may not be accounted for in the theory, and may be capable at predicting additional variance when tested quantitatively. Furthermore, qualitative research is important in medication adherence research as it allows both researchers and clinicians to further understand medication adherence, or non-adherence, from the patient’s point of view, rather than just their responses to self-report measures, which may be biased [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Application of Temporal Self-Regulation Theory to Understand Adherence to Simple and Complex Medication Regimens

et al. 2020

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Medication adherence is a global health concern, and variables of temporal self-regulation theory (TST) have been shown to be important in improving adherence. This qualitative study aims to explore how TST can help explain medication adherence in people’s daily lives, and whether there are differences in the adherence to simple and complex medication regimens. Twenty-nine participants from Australia engaged in semi-structured interviews based on TST (intention, behavioural prepotency, self-regulation), and other variables important to adherence. Interviews were analysed using thematic analysis. Six themes were identified (Routines, External Supports, Cost, Sense of Agency, Adverse Outcomes, and Weighing Up Pros and Cons), with partial support for TST (specifically intention, past behaviour, cues and planning). Four themes not related to TST were also identified. Individuals with more complex medication regimens spoke of the importance of routines, planning, and knowledge-seeking, whereas those with simpler regimens spoke of the importance of visual cues. TST may be useful for identifying some variables important in medication adherence, however, additional factors were also identified. For simple regimens, future research should focus on the manipulation of visual cues. For complex regimens, health professionals should consider supporting the use of medication management apps to assist in planning and ensuring a consistent routine.

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“…Our study also adds to understanding of forgetting as a reason for nonadherence (e.g., Gadkari & McHorney, 2012; McHorney, 2016) by identifying how participants with very low adherence normalized nonadherence by routinizing smaller, occasional lapses into a longer period described as forgetting, rather than nonadherence. Low adherers also contrasted forgetting with perfect adherence to persuade the listener that some adherence behavior was essentially unachievable, shutting down other explanations for nonadherence behavior that they found difficult to explain or did not understand.…”

Section: Discussionmentioning

confidence: 92%

“…However, this fails to recognize that taking recommended treatments may not be what individuals want because patients can make rational decisions to not adhere that make sense to them (Donovan & Blake, 1992). Thus, McHorney (2016) argued that nonadherence means that “issues important to the patient were not addressed” (p. 473). Furthermore, behavioral change may be difficult for individuals.…”

Section: Introductionmentioning

confidence: 99%

When Is Forgetting Not Forgetting? A Discursive Analysis of Differences in Forgetting Talk Between Adults With Cystic Fibrosis With Different Levels of Adherence to Nebulizer Treatments

et al. 2019

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Forgetting is often cited as a reason why people struggle to adhere to treatments for chronic conditions. Interventions have tried to improve forgetting behavior using reminders. We used a discursive psychological approach to explore differences in how high and low adherers constructed forgetting their nebulizer treatments for cystic fibrosis. Interviews were conducted with 18 adults from a cystic fibrosis center in the United Kingdom. High adherers constructed forgetting treatments as occasional lapses in automaticity and temporary lapses in memory that they found easy to repair. Low adherers utilized forgetting to normalize more consistent nonadherence to treatments. However, it is important to contextualize forgetting as a discursive resource that helped these participants to negotiate moral discourses around adherence to treatment that reminder interventions cannot address; we therefore recommend a more behavioral, patient-focused, theory-driven approach to intervention development.

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The Contribution of Qualitative Research to Medication Adherence

Cited by 6 publications

References 122 publications

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

A Qualitative Application of Temporal Self-Regulation Theory to Understand Adherence to Simple and Complex Medication Regimens

When Is Forgetting Not Forgetting? A Discursive Analysis of Differences in Forgetting Talk Between Adults With Cystic Fibrosis With Different Levels of Adherence to Nebulizer Treatments

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