title: A systematic review and thematic synthesis of patients' experience of medicines adherence.
abstract: Medicines non-adherence continues to be problematic in health care practice. After decades of research, few interventions have a robust evidence-based demonstrating their applicability to improve adherence. Phenomenology has a place within the health care research environment.
  
  
  
  To explore patients' lived experiences of medicines adherence reported in the phenomenonologic literature.
  
  
  
  A systematic literature search was conducted to identify peer-reviewed and published phenomenological investigations in adults that aimed to investigate patients' lived experiences of medicines adherence. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Research Tool. Thematic synthesis was conducted using a combination of manual coding and NVivo10 [QSR International, Melbourne] coding to aid data management.
  
  
  
  Descriptive themes identified included i) dislike for medicines, ii) survival, iii) perceived need, including a) symptoms and side-effects and b) cost, and iv) routine. Analytic themes identified were i) identity and ii) interaction.
  
  
  
  This work describes adherence as a social interaction between the identity of patients and medicines, mediated by interaction with family, friends, health care professionals, the media and the medicine, itself. Health care professionals and policy makers should seek to re-locate adherence as a social phenomenon, directing the development of interventions to exploit patient interaction with wider society, such that patients 'get to know' their medicines, and how they can be taken, throughout the life of the patient and the prescription.
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom.
authors.forename: A P
authors.initials: AP
authors.lastname: Rathbone
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Todd
authors.affiliation: School of Applied Social Sciences, Durham University, 32 Old Elvet, Durham DH1 3HN, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Jamie
authors.affiliation: AstraZeneca PLC, Charter Way, Macclesfield SK10 2NA, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Bonam
authors.affiliation: AstraZeneca PLC, Charter Way, Macclesfield SK10 2NA, United Kingdom.
authors.forename: L
authors.initials: L
authors.lastname: Banks
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom. Electronic address: a.k.husband@durham.ac.uk.
authors.forename: A K
authors.initials: AK
authors.lastname: Husband
mesh_terms: D003695:Delivery of Health Care / Q000379:methods; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055118:Medication Adherence; D010353:Patient Education as Topic / Q000379:methods*; D055553:Prescription Drugs / Q000008:administration & dosage*
chemical_list: D055553:Prescription Drugs
keywords: Medicines adherence; Phenomenology; Qualitative research; Social pharmacy; Thematic synthesis; Treatment compliance