Factors influencing long-term medication non-adherence among diabetes and hypertensive patients in Ghana: A qualitative investigation
Factors influencing long-term medication non-adherence among diabetes and hypertensive patients in Ghana: A qualitative investigation
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DOI：
10.1371/journal.pone.0193995
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发表时间：
2018-03-28
期刊：
影响因子：
3.7
通讯作者：
Gavu, Narissa Minta
中科院分区：
文献类型：
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作者：
Atinga, Roger A.;Yarney, Lily;Gavu, Narissa Minta
背景：为什么接受长期药物治疗的糖尿病和高血压患者漏服或停药的证据仍然有限。我们从加纳一家教学医院的糖尿病和高血压患者的角度研究了这一现象。方法2015年7月至12月，我们对库尔勒布教学医院因不遵医嘱再入院的慢性糖尿病和高血压患者及其护理人员进行了定性研究。参与者是有目的地抽样的，并使用采访指南进行了深入的采访。访谈的笔记和录音在Attride-Stirling建议的专题网络分析指导下进行转录、管理和编码。结果非依从性是由于认为药物对控制病情无效。有这些看法的患者拒绝药物治疗，转而将草药和精神治疗作为治疗替代方案，因为它们容易获得、疗效明显且价格合理。其他确定的影响不遵医嘱的因素包括多种用药实践；紧凑的工作时间表；社会规范;卫生保健提供者的处方指导不到位；以及药物的知识和经验。结论卫生服务提供者在给药时需要考虑患者的信仰、价值观和规范。入院时患者和护理人员对不依从性的影响的敏感化，以及对患者服药行为进行监测和提供反馈机制的干预措施，有望最大限度地提高糖尿病和高血压药物依从性。
BackgroundEvidence remains limited on why diabetes and hypertensive patients admitted to long-term drug therapy miss doses or discontinue medication taking. We examined this phenomenon from the perspective of diabetes and hypertension patients at a Ghanaian teaching hospital.MethodsBetween July and December 2015, we conducted a qualitative study targeting caregivers and their patients with chronic diabetes and hypertensive on re-admission at the Korle Bu Teaching Hospital due to non-adherence to prescribed medication. Participants were sampled purposefully and taking through in-depth interviews using an interview guide. Notes and audio recordings of interviews were transcribed, managed and coded for themes guided by the thematic network analysis recommended by Attride-Stirling.ResultsNon-adherence was the result of perceptions that the medications are not effective for managing the conditions. Patients with these perceptions rejected the medications and turned to herbal medicines and spiritual healing as therapeutic alternatives, because of their easy accessibility, perceived efficacy and affordability. Other factors identified to influence non-adherence included polypharmacy practice; tight work schedules; social norms; poor prescription instruction by health providers; and knowledge and experience of medication.ConclusionFindings suggests the need for health providers to adopt therapeutic approaches that take into account patients' beliefs, values and norms in administering medications. Sensitisation of patients and caregivers during admission on the implication of non-adherence, as well as interventions that monitor and provide feedback mechanisms on patients' medication taking behaviour holds promise for maximising diabetes and hypertensive medication adherence.