title: Resisting medicines: a synthesis of qualitative studies of medicine taking.
abstract: The study aimed to synthesise qualitative studies of lay experiences of medicine taking. Most studies focused on the experience of those not taking their medicine as prescribed, with few considering those who reject their medicines or accept them uncritically. Most were concerned with medicines for chronic illnesses. The synthesis revealed widespread caution about taking medicines and highlighted the lay practice of testing medicines, mainly for adverse effects. Some concerns about medicines cannot be resolved by lay evaluation, however, including worries about dependence, tolerance and addiction, the potential harm from taking medicines on a long-term basis and the possibility of medicines masking other symptoms. Additionally, in some cases medicines had a significant impact on identity, presenting problems of disclosure and stigma. People were found to accept their medicines either passively or actively, or to reject them. Some were coerced into taking medicines. Active accepters might modify their regimens by taking medicines symptomatically or strategically, or by adjusting doses to minimise unwanted consequences, or to make the regimen more acceptable. Many modifications appeared to reflect a desire to minimise the intake of medicines and this was echoed in some peoples' use of non-pharmacological treatments to either supplant or supplement their medicines. Few discussed regimen changes with their doctors. We conclude that the main reason why people do not take their medicines as prescribed is not because of failings in patients, doctors or systems, but because of concerns about the medicines themselves. On the whole, the findings point to considerable reluctance to take medicine and a preference to take as little as possible. We argue that peoples' resistance to medicine taking needs to be recognised and that the focus should be on developing ways of making medicines safe, as well as identifying and evaluating the treatments that people often choose in preference to medicines.
authors.affiliation: Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. pandora.pound@bristol.ac.uk
authors.forename: Pandora
authors.initials: P
authors.lastname: Pound
authors.forename: Nicky
authors.initials: N
authors.lastname: Britten
authors.forename: Myfanwy
authors.initials: M
authors.lastname: Morgan
authors.forename: Lucy
authors.initials: L
authors.lastname: Yardley
authors.forename: Catherine
authors.initials: C
authors.lastname: Pope
authors.forename: Gavin
authors.initials: G
authors.lastname: Daker-White
authors.forename: Rona
authors.initials: R
authors.lastname: Campbell
mesh_terms: D000328:Adult; D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D004364:Pharmaceutical Preparations; D012646:Self Administration / Q000523:psychology*; D016312:Treatment Refusal / Q000523:psychology*; D006113:United Kingdom
chemical_list: D004364:Pharmaceutical Preparations