Resilience of Medication Adherence Practices in Response to Life Changes: Learning from Qualitative Data Obtained during the COVID-19 Pandemic

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Abstract

Nonadherence to medicines is widespread and can adversely affect health outcomes. Previous research has identified that patients develop their own strategies to assist with adherence. However, such research has not focused on how the helpfulness of these strategies may change in response to changes in patients’ circumstances. This study aimed to explore resilience of medication adherence to life changes. It involved secondary thematic analysis of the verbatim transcripts of 50 semi-structured interviews that were conducted with adults who were advised to shield or were over the age of 70 during the first wave of the COVID-19 pandemic in the UK. Interview data suggested that resilience of medication adherence varied between participants. Participants either reported that they had not used any specific strategies to remind them to take their medicines prior to the pandemic, that the strategies that they had employed prior to the pandemic remained effective during the pandemic, that they had needed to make some adjustments to the strategies used, or that the strategies they had used were no longer effective. In addition, beliefs about medicines and motivation to take them were altered for some participants. These findings suggest that challenges associated with medication adherence do not always remain stable over time and that healthcare professionals need to continue to monitor and support medication adherence long-term.

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Using thematic analysis in psychology

Virginia Braun, Victoria Clarke (2014)

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Robby Nieuwlaat, Nancy J Wilczynski, Tamara Navarro … (2014)

People who are prescribed self administered medications typically take only about half their prescribed doses. Efforts to assist patients with adherence to medications might improve the benefits of prescribed medications.

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Is Open Access

Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework

Rob Horne, Sarah C E Chapman, Rhian Parham … (2014)

Background Patients’ beliefs about treatment influence treatment engagement and adherence. The Necessity-Concerns Framework postulates that adherence is influenced by implicit judgements of personal need for the treatment (necessity beliefs) and concerns about the potential adverse consequences of taking it. Objective To assess the utility of the NCF in explaining nonadherence to prescribed medicines. Data sources We searched EMBASE, Medline, PsycInfo, CDSR/DARE/CCT and CINAHL from January 1999 to April 2013 and handsearched reference sections from relevant articles. Study eligibility criteria Studies using the Beliefs about Medicines Questionnaire (BMQ) to examine perceptions of personal necessity for medication and concerns about potential adverse effects, in relation to a measure of adherence to medication. Participants Patients with long-term conditions. Study appraisal and synthesis methods Systematic review and meta-analysis of methodological quality was assessed by two independent reviewers. We pooled odds ratios for adherence using random effects models. Results We identified 3777 studies, of which 94 (N = 25,072) fulfilled the inclusion criteria. Across studies, higher adherence was associated with stronger perceptions of necessity of treatment, OR = 1.742, 95% CI [1.569, 1.934], p<0.0001, and fewer Concerns about treatment, OR = 0.504, 95% CI: [0.450, 0.564], p<0.0001. These relationships remained significant when data were stratified by study size, the country in which the research was conducted and the type of adherence measure used. Limitations Few prospective longitudinal studies using objective adherence measures were identified. Conclusions The Necessity-Concerns Framework is a useful conceptual model for understanding patients’ perspectives on prescribed medicines. Taking account of patients’ necessity beliefs and concerns could enhance the quality of prescribing by helping clinicians to engage patients in treatment decisions and support optimal adherence to appropriate prescriptions.