The meanings associated with medicines in heart failure patients.
BACKGROUND
The purpose of this study was to explore the theoretical linkages between symptom experiences and meaning associated with medication adherence. The specific objectives were to evaluate the key constructs of Meaning-Response theory for understanding medication adherence in patients with chronic heart failure; to assess the influence of symptom persistence on the meaning associated with prescribed medicines; and to explore the extent to which meaningful associations improve medication adherence. Among patients with heart failure, poor medication adherence occurs in over half of the population, resulting in high rates of symptom exacerbation, avoidable hospitalization, and death. Nurses play a key role in facilitating self-management skills, but patients' perceptions of the relationship between symptoms and medicines is not clear.


METHODS
Using a prospective mixed methods design, the study assessed patients' (n=10) perception of chronic heart failure symptoms and medication adherence. Patients completed guided interviews related to six concepts of meaning ascribed to medication use and four standardized measures of medication-related beliefs, behaviours, symptoms, and satisfaction.


RESULTS
This study suggests that patients' perception of meaning associated with medication taking was categorized as positive, negative, or absent. Symptom persistence influenced a majority of patient beliefs in the efficacy medicines, and patients with more positive meaningful associations with their medicines were more likely to remain adherent during the course of this study.


CONCLUSIONS
Development of meaningful associations with medicines may improve long-term adherence with prescribed medication in heart failure.
Duke University Health Systems, Durham, NC, USA.
Bradi B
BB
Granger
Kathryn
K
McBroom
Hayden B
HB
Bosworth
Adrian
A
Hernandez
Inger
I
Ekman
D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D012648:Self Care / Q000523:psychology*; D011795:Surveys and Questionnaires
D002317:Cardiovascular Agents