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"I don't know how many of these [medicines] are necessary.." - a focus group study among elderly users of multiple medicines
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. (The Pharmaceutical Outcomes Research Group)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. (The Pharmaceutical Outcomes Research Group)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. (The Pharmaceutical Outcomes Research Group)
The Swedish Association of the Pharmaceutical Industry.
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2009 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 74, no 2, 135-141 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The growing prevalence of multiple medicine use among elderly challenges health care. The aim was to conduct an exploratory study describing multiple medicine use from the elderly patient's perspective. METHODS: Twelve focus groups of 29 men and 30 women 65 years of age or older, using five or more medicines were analysed qualitatively. RESULTS: Initially the participants reported no problems with using multiple medicines; they felt fortunate that medicines existed and kept them alive. However, negative attitudes were also revealed, both similar to those presented in studies on lay experience of medicine-taking and some that appear more specific to users of multiple medicines. The foremost of these was that acceptance of medicines depends on not experiencing adverse effects and worrying whether multiple medicine use is 'good' for the body. Furthermore, participants' perception of their medicines depended on interaction with doctors, i.e. trusting 'good' doctors. CONCLUSION: The participants revealed co-existing accounts of both immediate gratitude and problems with using multiple medicines. Furthermore, the patient-doctor relationship coloured their attitudes towards their medicines. PRACTICE IMPLICATIONS: Importance of the patient-doctor relationship for treatment success is highlighted. Moreover, to be able to capture both accounts of the elderly in this study an appropriate consultation length is needed.

Place, publisher, year, edition, pages
2009. Vol. 74, no 2, 135-141 p.
Keyword [en]
Multiple medicine use, Elderly, Patient–doctor communication, Decision-making, Patient participation
National Category
Social and Clinical Pharmacy
Identifiers
URN: urn:nbn:se:uu:diva-104550DOI: 10.1016/j.pec.2008.08.019ISI: 000263407100002PubMedID: 18845412OAI: oai:DiVA.org:uu-104550DiVA: diva2:219938
Available from: 2009-05-28 Created: 2009-05-28 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Multiple Medicine Use: Patients’ and general practitioners’ perceptions and patterns of use in relation to age and other patient characteristics
Open this publication in new window or tab >>Multiple Medicine Use: Patients’ and general practitioners’ perceptions and patterns of use in relation to age and other patient characteristics
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There are widespread concerns about the increasing use of multiple medicines. The aims of this thesis were to identify older patients' and general practitioners' (GPs) attitudes to and experiences of multiple medicine use, as well as to describe patterns of multiple medicine use in different age groups in association with patient-related factors. An additional aim was to contribute to scientific methodological development by providing an empirical example of the application of the Lehoux, Poland, & Daudelin template for the analysis of interaction in focus groups. Data were collected via qualitative focus group discussions and from a cross-sectional community-based population survey conducted during 2001-2005.

The patients revealed co-existing accounts of both immediate gratitude that medicines exist and problems with using multiple medicines such as worrying whether multiple medicine use is 'good' for the body. The patient-doctor relationship coloured their attitudes towards their treatment and care.

The GPs at times felt insecure, though surrounded by treatment guidelines. Lack of communication with hospital specialists was perceived to reduce treatment quality, while influence of patient pressure was thought to contribute to the development of multiple medicine use. An interaction analysis helped in appreciating and clarifying the contexts in which results from the content analysis were created. Further discussion is needed on how to best report these results.

Different cut-offs are useful in defining multiple medicine use in different age groups. Vast majorities of users of multiple medicines were found to have unique medicine combinations. Multiple medicine use was found to be associated with morbidity and poor self-rated health across all age groups.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 77 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy, ISSN 1651-6192 ; 102
Keyword
Age groups, Focus group interaction analysis, General practitioners, Multiple medicine use, Patient-doctor communication, Patient-related factors, Polypharmacy
National Category
Social and Clinical Pharmacy
Research subject
Social Pharmacy
Identifiers
urn:nbn:se:uu:diva-106349 (URN)978-91-554-7564-2 (ISBN)
Public defence
2009-09-25, Auditorium Minus, Gustavianum, Akademigatan 3, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2009-09-02 Created: 2009-06-19 Last updated: 2009-09-02Bibliographically approved

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