title: Patients' Perspective of Medication Adherence in Chronic Conditions: A Qualitative Study.
abstract: About 50% of patients do not take their long-term therapy for chronic conditions as prescribed. Many studies have centered on patients' adherence to a specific treatment or single conditions, but few have taken all chronic conditions into consideration from a patient's perspective. This study aims to explore factors that impact on drug compliance and to identify strategies to improve this from the perspective of patients with at least one chronic condition.
  
  
  
  Patients were recruited by healthcare professionals from a hospital pharmacy, four community pharmacies, patient associations, and a primary care center in Barcelona. Five focus groups were conducted (N = 36). Conversations were audiotaped and transcribed verbatim to allow qualitative analysis.
  
  
  
  Study subjects were aged 39-90 years (mean 65 years) and the mean number of comorbidities per patient was 2.3 (range 1-7). The main modifiers of therapeutic conduct were: patients' health beliefs, patient-prescriber relationships, and patients' motivation and perception of illness control. Study participants wanted greater participation in decision-making concerning their health and increased education about their illness and medication. They also wanted individualized healthcare that took their preferences and personal and emotional issues into account.
  
  
  
  Our results highlight how the patient-prescriber's relationship and factors such as health beliefs, motivation and perception of illness control impact on medication adherence in chronic patients. Future interventions to optimize adherence to treatment should focus on shared decision-making and more extensive health education.
  
  
  
  Celgene Corporation.
authors: Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. npages@santpau.cat.|PhD Programme in Pharmacy, University of Granada, Granada, Spain. npages@santpau.cat.
authors: Neus
authors: 0000-0003-4788-2728
authors: N
authors: Pagès-Puigdemont
authors: Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.|PhD Programme in Pharmacy, University of Granada, Granada, Spain.|CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain.
authors: Maria Antònia
authors: MA
authors: Mangues
authors: Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: Montserrat
authors: M
authors: Masip
authors: Fundació Salut i Envelliment, Universitat Autònoma de Barcelona, Barcelona, Spain.|Department of Sociology, Faculty of Economics and Business, University of Barcelona, Barcelona, Spain.
authors: Giovanna
authors: G
authors: Gabriele
authors: Fundació Salut i Envelliment, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: Laura
authors: L
authors: Fernández-Maldonado
authors: Fundació Salut i Envelliment, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: Sergi
authors: S
authors: Blancafort
authors: Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.|PhD Programme in Pharmacy, University of Granada, Granada, Spain.
authors: Laura
authors: L
authors: Tuneu
mesh_terms: D001294:Attitude to Health; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy; D015897:Comorbidity; D003657:Decision Making; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D011320:Primary Health Care / Q000379:methods; D011369:Professional-Patient Relations; D036301:Qualitative Research
keywords: Chronic patients; Medication adherence; Shared decision-making; Therapeutic adherence; Therapeutic alliance