Chronic patients perceive conflicting information on their medications: in-depth qualitative interviews
- At: PPR 2022 (2022)
- Type: Poster
- By: SANTOS, Beatriz (Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland)
- Co-author(s): Beatriz Santos, Phd Student, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Switzerland
Katherine Blondon, Medical Directorate, University Hospitals of Geneva, Switzerland
Elisabeth Van Gessel, Interprofessional Simulation Center, University of Geneva , Switzerland
Delesha Carpenter, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, United States of America
Context: Patients with multiple chronic diseases visit various healthcare professionals and are exposed to medication information from different sources which, when not concerted, cause an increased potential risk of patients’ perceptions of contradictory medication information. A quantitative study conducted in 2019 revealed that 47% of chronic patients had perceived conflicting information regarding one or more medications in the previous 12 months.
Objectives: The aim of this study is (i) to characterize conflicting medication information perceived by patients with chronic diseases and (ii) to better understand the related impact on chronic patients’ medication self-management and healthcare system navigation.
Design: Qualitative semi-structured interviews
Setting: Outpatients visiting community pharmacies and medical centers in Geneva, Switzerland,
Participants: This study included 22 chronic patients from April 2019 to February 2020. Patients were included after participating in the epidemiology survey of the same study . Inclusion criteria for this qualitative part were: (i) taking at least one medication for at least 6 months; (ii) having visited at least two prescribers in the past three months; (iii) being able to communicate in French, English, Portuguese or Spanish; and (iv) having described at least one perceived conflicting information regarding their medication in the past twelve months, while filling in the quantitative survey.
Methods: Semi-structured audiotaped interviews of 20 to 60 minutes based on an interview guide to explore participants’ perceptions of conflicting information. Interviews were transcribed verbatim and coded using MaxQda™ Each interview was coded independently by two researchers using a comparative approach. A reflexive thematic analysis was used as theoretical approach, which allowed identifying themes related to participants’ experiences and perspectives.
Results: Participants mentioned professional sources such as general practitioners, medical specialists, and pharmacists as main sources of conflicting medication information. Lack of time, insufficient information provided and a poor communication among healthcare professionals and with the patient were described as possible causes for such conflicting information. Other than the impact on the patients’ care trajectory by visiting multiple healthcare professionals for a different opinion, conflicting information affected medication adherence, often by not taking the medication as prescribed but also by not initiating the treatment or by temporarily stopping it without any healthcare professional advice. Finally, for many participants, feelings or emotions such as fear, anxiety, anger or even guilt originated from perceived conflicting information, which sometimes prevented the patients in participating in the shared decision making process.
Conclusion: New interprofessional models of care with more efficient and seamless communication among healthcare professionals are essential to respond to the evolving needs of chronic outpatients regarding their medication. To our knowledge, little is still known about the way in which chronic patients respond to conflicting information and how it affects the decision-making process regarding medication management.