Table 3 Adherence factors to medication use according to healthcare professionals in this study
Categories | Facilitators | Barriers |
|---|---|---|
Patient-related | Self-managing medication regimen such as: Embedding medication intake in daily routine; Tapering/dosing/discontinuing temporarily; Managing medication stock at home | Experiencing redefinition of identity |
Personality traits such as openness and conscientiousness | Feeling resistance to become dependent on (lifelong) medication | |
Pursuing a solution-oriented approach | Denying the existence of condition | |
Pursuing discipline in medication taking | Experiencing inner conflict of medication necessity versus concerns | |
Coping with insecurity how future/condition will unfold, having a realistic expectation | Lacking confidence and/or not feeling safe enough to talk about e.g. (non) adherence | |
Maintaining autonomy and improving quality of life | Having trouble to understand instruction inserts | |
Being able to take care of family | Not believing in prescribed treatment, preferring traditional medication | |
Being able to open medication bottles/packages and administer injections/oral medications | Not believing that medication will always be available | |
Using aids to remember/motivate adherence | Not believing that condition needs (lifelong) medication | |
Believing in positive treatment effect | Believing that the condition can be cured | |
Experiencing positive emotions evoked by (positive experience of) medication | Attributing decreased treatment effect due to non-medical switch | |
Experiencing negative emotions that are evoked by using medication for a chronic condition | ||
Therapy-related | Experiencing a short-term onset of medication effectiveness | Experiencing side effects |
Experiencing positive treatment effect | Dreading possible interactions (medications, alcohol) | |
Employing a dose-reducing strategy | Being confronted with changed appearance of medication | |
Aligning patient preferences for medication administration | Perceiving information overload | |
Dealing with complexity of instruction inserts | ||
Condition-related | Experiencing high level of disease activity | Perceiving treatment as redundant without a definite diagnosis |
Experiencing a poor general health status e.g. suffering comorbidities (poly pharmacy) | ||
Healthcare team and system-related | Providing tailored information frequently | Imposing limited consultation time to discuss choice of medication |
Discussing reasons for non-adherence before and during therapy | Lacking reimbursement medication | |
HCPs are more accessible for patients (by different channels) | ||
Offering optimal service logistics medication | ||
Creating bond/empathy/trust with patient | ||
Physician’s positive attitude on medication use | ||
Initiating shared decision-making process by HCPs | ||
Social and Economic | Receiving social and work-related support | Travelling |
Nature of work hindering medication use (shifts) | ||
Perceiving negative impact of social media/internet | ||
Perceiving negative experiences/stories from others about medication | ||
Interference in medication use because of religious or cultural customs |