title: Issues potentially affecting quality of life arising from long-term medicines use: a qualitative study.
abstract: BACKGROUND
  Polypharmacy is increasing and managing large number of medicines may create a burden for patients. Many patients have negative views of medicines and their use can adversely affect quality of life. No studies have specifically explored the impact of general long-term medicines use on quality of life.
  
  
  OBJECTIVE
  To determine the issues which patients taking long-term medicines consider affect their day-to-day lives, including quality of life.
  
  
  METHODS
  Four primary care general practices in North West England.
  
  
  METHODS
  Face-to-face interviews with adults living at home, prescribed four or more regular medicines for at least 1 year. Interviewees were identified from primary care medical records and purposively selected to ensure different types of medicines use. Interviews were recorded, transcribed and analysed thematically.
  
  
  RESULTS
  Twenty-one interviews were conducted and analysed. Patients used an average of 7.8 medicines, 51 % were preventive, 40 % for symptom relief and 9 % treatment. Eight themes emerged: relationships with health professionals, practicalities, information, efficacy, side effects, attitudes, impact and control. Ability to discuss medicines with health professionals varied and many views were coloured by negative experiences, mainly with doctors. All interviewees had developed routines for using multiple medicines, some requiring considerable effort. Few felt able to exert control over medicines routines specified by health professionals. Over half sought additional information about medicines whereas others avoided this, trusting in doctors to guide their medicines use. Patients recognised their inability to assess efficacy for many medicines, notably those used for prophylaxis. All were concerned about possible side effects and some had poor experiences of discussing concerns with doctors. Medicines led to restrictions on social activities and personal life to the extent that, for some, life can revolve around medicines.
  
  
  CONCLUSIONS
  There is a multiplicity and complexity of issues surrounding medicines use, which impact on day-to-day lives for patients with long-term conditions. While most patients adapt to long-term medicines use, others did so at some cost to their quality of life.
authors.affiliation: School of Pharmacy, Universities of Greenwich and Kent, Chatham Maritime, Kent, ME4 4TB, UK, j.krska@kent.ac.uk.
authors.forename: Janet
authors.initials: J
authors.lastname: Krska
authors.forename: Charles W
authors.initials: CW
authors.lastname: Morecroft
authors.forename: Helen
authors.initials: H
authors.lastname: Poole
authors.forename: Philip H
authors.initials: PH
authors.lastname: Rowe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064420:Drug-Related Side Effects and Adverse Reactions / Q000523:psychology*; D004739:England; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D019338:Polypharmacy; D011320:Primary Health Care; D011788:Quality of Life; D013997:Time Factors; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations