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Adherence to multiple, prescribed medications in diabetic kidney disease: A qualitative study of consumers' and health professionals' perspectives.
journal contribution
posted on 2008-12-01, 00:00 authored by A F Williams, Elizabeth ManiasElizabeth Manias, R WalkerBACKGROUND: Individuals are adherent to approximately 50% of their prescribed medications, which decreases when multiple, chronic conditions are involved. OBJECTIVE: To examine factors affecting adherence to multiple prescribed medications for consumers with co-existing diabetes and chronic kidney disease (diabetic kidney disease) from the time of prescription to the time they took their medications. DESIGN: A descriptive exploratory design was used incorporating in-depth interviews and focus groups. SETTING: The diabetes and nephrology departments of two metropolitan, public hospitals in Melbourne, Australia. PARTICIPANTS: A convenience sample of 23 consumers with diabetic kidney disease participated in an in-depth interview. Inclusion criteria involved English-speaking individuals, aged > or =18 years, with co-existing diabetes and chronic kidney disease, and who were mentally competent. Exclusion criteria included impending commencement on dialysis, pregnancy, an aggressive form of cancer, or a mental syndrome that was not stabilised with medication. Sixteen health professionals working in diabetes and nephrology departments in Melbourne, Australia also participated in one of two focus groups. METHODS: In-depth structured interviews and focus groups were conducted and analysed according to a model of medication adherence. RESULTS: Consumers were not convinced of the need, effectiveness and safety of all of their medications. Alternatively, health professionals focussed on the importance of consumers taking their medications as prescribed and believed that the risk of medication-related adverse effects was over-rated. Accessing prescribed medications and difficulties surrounding continuity of care contributed to consumers' unintentional medication non-adherence. In particular, it was hard for consumers to persist taking their ongoing medication prescriptions. Healthcare system inadequacies were highlighted, which affected relationships between consumers with diabetic kidney disease and health professionals. CONCLUSIONS: Acknowledging the barriers as perceived by consumers with diabetic kidney disease can facilitate effective communication and partnerships with health professionals necessary for medication adherence and medication safety.
History
Journal
International Journal of Nursing StudiesVolume
45Issue
12Pagination
1742 - 1756Publisher
ElsevierLocation
London, Eng.Publisher DOI
ISSN
0020-7489Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2008, ElsevierUsage metrics
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No categories selectedKeywords
Adaptation, PsychologicalAdultAdherenceAgedAttitude of Health PersonnelChronic diseaseComorbidityDiabetic NephropathiesFemaleFocus GroupsHealth Knowledge, Attitudes, PracticeHealth Services Needs and DemandHumansMaleMedicationMiddle AgedModels, PsychologicalNursing Methodology ResearchPatient Education as TopicPersonnel, HospitalPolypharmacyPrescription DrugsQualitative ResearchSurveys and QuestionnairesVictoriaScience & TechnologyLife Sciences & BiomedicineNursingRISK-FACTORSACUTE-CARECOMORBIDITIESNONADHERENCEPERCEPTIONSMEDICINESAUSTRALIA
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