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Patient and Caregiver Priorities for Medication Adherence in Gout, Osteoporosis, and Rheumatoid Arthritis: Nominal Group Technique
Author(s) -
Kelly Ayano,
Tymms Kathleen,
Wit Maarten,
Bartlett Susan J.,
Cross Marita,
Dawson Therese,
De Vera Mary,
Evans Vicki,
Gill Michael,
Hassett Geraldine,
Lim Irwin,
Manera Karine,
Major Gabor,
March Lyn,
O’Neill Sean,
Scholte-Voshaar Marieke,
Sinnathurai Premarani,
Sumpton Daniel,
TeixeiraPinto Armando,
Tugwell Peter,
Bemt Bart,
Tong Allison
Publication year - 2020
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.24032
Subject(s) - medicine , rheumatoid arthritis , family medicine , focus group , medication adherence , physical therapy , osteoporosis , gout , qualitative research , social science , marketing , sociology , business
Objective This study aimed to identify and prioritize factors important to patients and caregivers with regard to medication adherence in gout, osteoporosis (OP), and rheumatoid arthritis (RA) and to describe the reasons for their decisions. Methods Patients with gout, OP, and RA and their caregivers, purposively sampled from 5 rheumatology clinics in Australia, identified and ranked factors that they considered important for medication adherence using nominal group technique and discussed their decisions. An importance score (IS; scale 0–1) was calculated, and qualitative data were analyzed thematically. Results From 14 focus groups, 82 participants (67 patients and 15 caregivers) identified 49 factors. The top 5 factors based on the ranking of all participants were trust in doctor (IS 0.46), medication effectiveness (IS 0.31), doctor’s knowledge (IS 0.25), side effects (IS 0.23), and medication‐taking routine (IS 0.13). The order of the ranking varied by participant groupings, with patients ranking “trust in doctor” the highest, while caregivers ranked “side effects” the highest. The 5 themes reflecting the reasons for factors influencing adherence were as follows: motivation and certainty in supportive individualized care; living well and restoring function; fear of toxicity and cumulative harm; seeking control and involvement; and unnecessarily difficult and inaccessible. Conclusion Factors related to the doctor, medication properties, and patients’ medication knowledge and routine were important for adherence. Strengthening doctor–patient trust and partnership, managing side effects, and empowering patients with knowledge and skills for taking medication could enhance medication adherence in patients with rheumatic conditions.