Understanding the meaning of medications for patients: the medication experience.
OBJECTIVE
To understand and describe the meaning of medications for patients.


METHODS
A metasynthesis of three different, yet complementary qualitative research studies, was conducted by two researchers. The first study was a phenomenological study of patients' medication experiences that used unstructured interviews. The second study was an ethnographic study of pharmaceutical care practice, which included participant observation, in-depth interviews and focus groups with patients of pharmaceutical care. The third was a phenomenological study of the chronic illness experience of medically uninsured individuals in the United States and included an explicit aim to understand the medication experience within that context. The two researchers who conducted these three qualitative studies that examined the medication experience performed the meta-synthesis. The process began with the researchers reviewing the themes of the medication experience for each study. The researchers then aggregated the themes to identify the overlapping and similar themes of the medication experience and which themes are sub-themes within another theme versus a unique theme of the medication experience. The researchers then used the analytic technique, "free imaginative variation" to determine the essential, structural themes of the medication experience.


RESULTS
The meaning of medications for patients was captured as four themes of the medication experience: a meaningful encounter; bodily effects; unremitting nature; and exerting control. The medication experience is an individual's subjective experience of taking a medication in his daily life. It begins as an encounter with a medication. It is an encounter that is given meaning before it occurs. The experience may include positive or negative bodily effects. The unremitting nature of a chronic medication often causes an individual to question the need for the medication. Subsequently, the individual may exert control by altering the way he takes the medication and often in part because of the gained expertise with the medication in his own body.


CONCLUSIONS
The medication experience is a practice concept that serves to understand patients' experiences and to understand an individual patient's medication experience and medication-taking behaviors in order to meet his or her medication-related needs.
Shoemaker
Sarah J
SJ
Health Policy, Abt Associates Inc, 55 Wheeler Street, Cambridge, MA 02138, US. sarah_shoemaker@abtassoc.com
Ramalho de Oliveira
Djenane
D
D001294:Attitude to Health; D004358:Drug Therapy / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D010342:Patient Acceptance of Health Care; D010361:Patients / Q000523:psychology*; D010593:Pharmaceutical Services; D036301:Qualitative Research; D012646:Self Administration / Q000523:psychology; D014481:United States