Preserving self: medication‐taking practices and preferences of older adults with multiple chronic medical conditions
R Vandermause, JJ Neumiller, BJ Gates… - Journal of Nursing …, 2016 - Wiley Online Library
Journal of Nursing Scholarship, 2016•Wiley Online Library
Purpose To examine the experiences of older adults with multiple chronic medical
conditions when a new medication was added to their existing multiple medication regimen.
Design A multimethod qualitative design was used. Thirty adults 60 years of age with (a) at
least three chronic medical diagnoses,(b) at least five medications at baseline, and (c) a new
medication prescription were enrolled in a prospective study of 30 days duration,
participating from their homes. Methods In‐depth hermeneutic interviews (2 per 15 …
conditions when a new medication was added to their existing multiple medication regimen.
Design A multimethod qualitative design was used. Thirty adults 60 years of age with (a) at
least three chronic medical diagnoses,(b) at least five medications at baseline, and (c) a new
medication prescription were enrolled in a prospective study of 30 days duration,
participating from their homes. Methods In‐depth hermeneutic interviews (2 per 15 …
Purpose
To examine the experiences of older adults with multiple chronic medical conditions when a new medication was added to their existing multiple medication regimen.
Design
A multimethod qualitative design was used. Thirty adults 60 years of age with (a) at least three chronic medical diagnoses, (b) at least five medications at baseline, and (c) a new medication prescription were enrolled in a prospective study of 30 days duration, participating from their homes.
Methods
In‐depth hermeneutic interviews (2 per 15 participants) and self‐assessment diaries recorded on electronic tablets (daily per 30 participants) were completed. Transcribed interviews and self‐recorded survey data were analyzed using hermeneutical analysis and ecological momentary assessment and content analysis, respectively.
Findings
Common reasons participants did not take medications as prescribed included tolerability, transportation, access to medications, and forgetting. The overarching pattern, “preserving self,” was supported by two patterns that subsumed several themes: (a) engaging the powerful hold of my illness, and (b) engaging providers in visioning health.
Conclusions
A deeper understanding of the impact of receiving a new prescription and of managing medication reveals the challenges patients experience in preserving a sense of self. Healthcare providers of all disciplines should understand the meaning of medication prescribing and medication taking to ameliorate medication‐taking difficulties.
Clinical Relevance
The provider–patient relationship is often cited as an area that needs to be addressed in healthcare practice. Our study emphasized the patients’ voices and their profound needs around medication management. The emphasis on preservation of self is an important finding that focalizes the concern.
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