Patient Perspectives on Factors Influencing Medication Adherence Among People with Coronary Heart Disease

Background: Few qualitative studies have explored factors influencing medication adherence among people with coronary heart disease (CHD) or CHD risk factors. We explored how factors related to the patient (e.g. self-efficacy), social/economic conditions (e.g. social support and cost of medications)...

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Bibliographic Details
Published in:Patient preference and adherence 2020-03, p.2017
Main Authors: Mukerji, Reshmi, Mondesir, Favel L, Levitan, Emily B, Malla, Gargya, Turan, Janet M, Carson, April P, Safford, Monika M
Format: Article
Language:English
Subjects:
Ambulatory care
Antihypertensive agents
Black women
Cardiovascular diseases
Comorbidity
Coronary heart disease
Desire
Diseases
Drugs
Drugstores
Faith
Health care industry
Heart diseases
Hypertension
Medical research
Patient compliance
Pharmacists
Pharmacy
Public health
Qualitative research
Risk factors
Social aspects
Social networks
Social support
White women
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Summary:Background: Few qualitative studies have explored factors influencing medication adherence among people with coronary heart disease (CHD) or CHD risk factors. We explored how factors related to the patient (e.g. self-efficacy), social/economic conditions (e.g. social support and cost of medications), therapy (e.g. side effects), health condition (e.g. comorbidities), and the healthcare system/healthcare team (e.g. support from healthcare providers and pharmacy access) influence medication adherence, based on the World Health Organization Multidimensional Adherence Model (WHO-MAM). Methods: We conducted 18 in-depth qualitative interviews from April to July 2018 with ambulatory care patients aged >45 years (8 black men, 5 black women, 2 white men, and 3 white women) who were using medications for diabetes, hypertension, dyslipidemia and/or CHD. We used thematic analysis to analyze the data, and sub-themes emerged within each WHO-MAM dimension. Findings: Patient-related factors included beliefs about medications as important for self and faith; the desire to follow the advice of family, friends, and influential others; and self-efficacy. Social/economic factors included observations of social network members and information received from them; social support for medication adherence and pharmacy utilization; and economic influences. Therapy-related barriers included side effects and medicine schedules. Only a few participants mentioned condition-related factors. Healthcare system/healthcare team-related factors included support from doctors and pharmacists; and ease of pharmacy access and utilization. Conclusion: These results underscore the need for multidimensional interventions aimed at improving medication adherence and overall health of patients with CHD and CHD risk factors. Keywords: medication adherence, qualitative research, coronary heart disease, diabetes, hypertension, dyslipidemia
ISSN:1177-889X
1177-889X