Exploring motivation and confidence in taking prescribed medicines in coexisting diseases: a qualitative study

Williams,Allison and Manias,E 2014, Exploring motivation and confidence in taking prescribed medicines in coexisting diseases: a qualitative study, Journal of clinical nursing, vol. 23, no. 3-4, pp. 471-481, doi: 10.1111/jocn.12171.

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Title Exploring motivation and confidence in taking prescribed medicines in coexisting diseases: a qualitative study
Author(s) Williams,Allison
Manias,EORCID iD for Manias,E orcid.org/0000-0002-3747-0087
Journal name Journal of clinical nursing
Volume number 23
Issue number 3-4
Start page 471
End page 481
Total pages 11
Publisher Wiley
Place of publication London, Eng.
Publication date 2014-02
ISSN 0962-1067
1365-2702
Keyword(s) Comorbidities
Diabetes
Emotional support
Hypertension
Kidney disease
Medication adherence
Motivational interviewing
Self-management
Summary Aims and objectives: To explore the motivation and confidence of people with coexisting diabetes, chronic kidney disease (CKD) and hypertension to take their medicines as prescribed. Background: These comorbidities are major contributors to disease burden globally. Self-management of individuals with these coexisting diseases is much more complicated than that of those with single diseases and is critical for improved health outcomes. Design: Motivational interviewing telephone calls were made with participants with coexisting diabetes, CKD and hypertension. Methods: Patients aged ≥18 years with diabetes, CKD and systolic hypertension were recruited from outpatient clinics of an Australian metropolitan hospital between 2008-2009. An average of four motivational interviewing telephone calls was made with participants (n = 39) in the intervention arm of a randomised controlled trial. Data were thematically analysed using the modified Health Belief Model as a framework. Results: Participants' motivation and confidence in taking prescribed medicines was thwarted by complex medicine regimens and medical conditions. Participants wanted control over their health and developed various strategies to confront threats to health. The perceived barriers of taking recommended health action outweighed the benefits of taking medicines as prescribed and were primarily related to copious amounts of medicines. Conclusion: Taking multiple prescribed medicines in coexisting diabetes, CKD and hypertension is a perpetual vocation with major psychosocial effects. Participants were overwhelmed by the number of medicines that they were required to take. The quest for personal control of health, fear of the future and the role of stress and gender in chronic disease management have been highlighted. Participants require supportive emotional interventions to self-manage their multiple medicines on a daily basis. Relevance to clinical practice: Reducing the complexity of medicine regimens in coexisting diseases is paramount. Individualised psychosocial approaches that address the emotional needs of patients with regular follow-up and feedback are necessary for optimal chronic disease self-management. © 2013 John Wiley & Sons Ltd.
Language eng
DOI 10.1111/jocn.12171
Field of Research 111099 Nursing not elsewhere classified
Socio Economic Objective 920210 Nursing
HERDC Research category C1.1 Refereed article in a scholarly journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30069630

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