A systematic review and thematic synthesis of patients' experience of medicines adherence

Res Social Adm Pharm. 2017 May-Jun;13(3):403-439. doi: 10.1016/j.sapharm.2016.06.004. Epub 2016 Jun 23.

Abstract

Background: Medicines non-adherence continues to be problematic in health care practice. After decades of research, few interventions have a robust evidence-based demonstrating their applicability to improve adherence. Phenomenology has a place within the health care research environment.

Objective: To explore patients' lived experiences of medicines adherence reported in the phenomenonologic literature.

Methods: A systematic literature search was conducted to identify peer-reviewed and published phenomenological investigations in adults that aimed to investigate patients' lived experiences of medicines adherence. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Research Tool. Thematic synthesis was conducted using a combination of manual coding and NVivo10 [QSR International, Melbourne] coding to aid data management.

Results: Descriptive themes identified included i) dislike for medicines, ii) survival, iii) perceived need, including a) symptoms and side-effects and b) cost, and iv) routine. Analytic themes identified were i) identity and ii) interaction.

Conclusions: This work describes adherence as a social interaction between the identity of patients and medicines, mediated by interaction with family, friends, health care professionals, the media and the medicine, itself. Health care professionals and policy makers should seek to re-locate adherence as a social phenomenon, directing the development of interventions to exploit patient interaction with wider society, such that patients 'get to know' their medicines, and how they can be taken, throughout the life of the patient and the prescription.

Keywords: Medicines adherence; Phenomenology; Qualitative research; Social pharmacy; Thematic synthesis; Treatment compliance.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Delivery of Health Care / methods
  • Evidence-Based Medicine
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Medication Adherence*
  • Patient Education as Topic / methods*
  • Prescription Drugs / administration & dosage*

Substances

  • Prescription Drugs