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Associate Professor, School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
Research Associate, School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne
Rheumatologist, School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne
at time of writing, Associate Professor and Director of Research and Staff Development, School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne; Department of Nursing, Western Hospital; now, Deakin-Cabrini Health Chair in Nursing
Director of Clinical Epidemiology and Health Care Evaluation Unit and Rheumatologist, Clinical Epidemiology and Health Care Evaluation Unit, The Royal Melbourne Hospital
Reprints: Dr. Manias, School of Nursing, The University of Melbourne, Level 1, 723 Swanston St., Carlton Victoria, Melbourne, Australia, fax 61 3 9347 4172, emanias{at}unimelb.edu.au
BACKGROUND: Managing medications is complex, particularly for consumers with multiple coexisting conditions for whom benefits and adverse effects are unpredictable and health priorities may be variable.
OBJECTIVE: To investigate perceptions of and experiences with managing drug regimens from the perspectives of consumers with osteoarthritis and coexisting chronic conditions and of healthcare professionals from diverse backgrounds.
METHODS: Using an exploratory research design, focus groups were formed with 34 consumers and 19 healthcare professionals. Individual interviews were undertaken with 3 community medical practitioners.
RESULTS: Consumers' management of medications was explored in terms of 3 themes: administration of medications, provision of information, and the perceived role of healthcare professionals. In general, consumers lacked understanding regarding the reason that they were prescribed certain medications. Since all consumer participants had at least 2 chronic conditions, they were taking many drugs to relieve undesirable symptoms. Some consumers were unable to achieve improved pain relief and were reluctant to take analgesics prescribed on an as - needed basis. Healthcare professionals discussed the importance of using non-pharmacologic measures to improve symptoms; however, consumers stated that physicians encourage them to continue using medications, often for prolonged periods, even when these agents are not helpful.
CONCLUSIONS: Consumers were dissatisfied about the complexity of their medication regimens and also lacked understanding as to how to take their drugs effectively. Dedicated time should be devoted during medical consultations to facilitate verbal exchange of information about medications. Pharmacists must communicate regularly with physicians about consumers' medication needs to help preempt any problems that may arise. Instructions need to be revised through collaboration between physicians and pharmacists so that "as needed" directions provide more explicit advice about when and how to use such drugs. Future research, using large, generalizable samples, should examine trends related to consumers' experiences of symptomatic relief from chronic conditions and their understandings about medications.
Key Words: consumer, drug information, osteoarthritis, pain
Published Online, April 24, 2007. www.theannals.com, DOI 10.1345/aph.1H623
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