Barriers and facilitators to medication adherence: a qualitative study with general practitioners
Barriers and facilitators to medication adherence: a qualitative study with general practitioners
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DOI：
10.1136/bmjopen-2016-015332
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发表时间：
2018-01-01
期刊：
影响因子：
2.9
通讯作者：
Liira, Helena
中科院分区：
文献类型：
--
作者：
Kvarnstrom, Kirsi;Airaksinen, Marja;Liira, Helena
背景全科医生管理慢性病患者的药物治疗，服药依从性差仍然是一个主要的挑战。本定性研究考察了全科医生对药物不依从性的洞察力和克服这一问题的方法。方法我们在芬兰南部的Kirkkonummi健康中心进行了4个焦点小组，包括16名全科医生。访谈被录音，逐字转录，并通过归纳内容分析进行分析。主要结果与全科医生讨论的两个主要主题是在慢性病护理方面的不坚持和对药物信息的需求增加。确定的药物管理挑战涉及：患者特定因素、医疗保健系统、药物治疗的特点以及医疗保健专业人员作为一个团队的功能和作用。为了改善这种情况，全科医生提供了一些解决方案：改善护理协调，更好的患者教育和信息技术系统，以及加强跨专业人员对患者随访的参与。讨论和结论随着人口老龄化，全科医生在慢性病护理方面面临越来越多的不遵守。他们大多对以更多跨专业的方式组织护理持积极态度。为了支持服药依从性和自我管理，全科医生感谢药剂师的帮助，特别是对患有多种药物和慢性病的患者。
Background General practitioners (GPs) manage the drug therapies of people with chronic diseases, and poor adherence to medication remains a major challenge.Objective This qualitative study examined GPs' insights into non-adherence and ways of overcoming this problem.Methods We ran four focus groups comprising 16 GPs at the Kirkkonummi Health Centre (Southern Finland). Interviews were audiotaped, transcribed verbatim and analysed by inductive content analysis.Main results The two main themes in the discussions with the GPs were non -adherence in the care of chronic disease and increased need for medicine information. The medication management challenges identified were related to: patient-specific factors, the healthcare system, characteristics of drug therapies and the function and role of healthcare professionals as a team. To improve the situation, the GPs offered a number of solutions: improved coordination of care, better patient education and IT systems as well as enhanced interprofessional involvement in the follow-up of patients.Discussion and conclusions With an ageing population, the GPs were increasingly confronted with non -adherence in the care of chronic diseases. They had mostly a positive attitude towards organising care in a more interprofessional manner. To support medication adherence and self-management, the GPs appreciated pharmacists' assistance especially with patients with polypharmacy and chronic diseases.