title: Patient perspectives on multiple medications versus combined pills: a qualitative study.
abstract: BACKGROUND
  A growing number of patients are taking multiple medications. Unfortunately, adherence may fall as drug numbers and procedural complexity increase. While there are plausible theoretical reasons why combining pills might improve non-adherence, patients' attitudes are unknown.
  
  
  OBJECTIVE
  To explore attitudes and practices to medication regimens among patients already in receipt of multiple medications, and to assess whether a combined tablet would be perceived as advantageous.
  
  
  METHODS
  Qualitative study.
  
  
  METHODS
  Ninety-two men and women aged >40 years currently receiving both antihypertensive and cholesterol-lowering medications took part in 14 focus groups.
  
  
  RESULTS
  Drugs were seen as unwelcome but necessary. Some took drugs flexibly by changing dose timing, thereby increasing the complexity of their regimen. A routine was seen as the key to coping with multiple medications, although it was sometimes threatened by changes in prescriptions and life circumstances. While some participants welcomed a combined pill, there was uncertainty about whether a combination that mirrored their current doses would be available. There were also concerns about tablet size, allergies, the attribution of side-effects, timing of tablets throughout the day, and the ability to alter dose levels.
  
  
  CONCLUSIONS
  While some patients would be willing to try a combined pill and would appreciate the associated convenience, they are likely to have a number of concerns that prescribers should address. Willingness to move to combined therapy may be hindered if drug combinations that mirror personalized and trusted regimens are not available.
authors.affiliation: Division of Community Health Sciences, University of Dundee. b.y.williams@chs.dundee.ac.uk
authors.forename: B
authors.initials: B
authors.lastname: Williams
authors.forename: A
authors.initials: A
authors.lastname: Shaw
authors.forename: R
authors.initials: R
authors.lastname: Durrant
authors.forename: I
authors.initials: I
authors.lastname: Crinson
authors.forename: C
authors.initials: C
authors.lastname: Pagliari
authors.forename: S
authors.initials: S
authors.lastname: de Lusignan
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D019338:Polypharmacy; D012646:Self Administration; D011795:Surveys and Questionnaires
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D004338:Drug Combinations