Adherence to Treatment in Patients with Chronic Diseases: From Alertness to Persistence

Document Type : Original Article

Authors

1 Department of Health Sciences, Mid Sweden University, Östersund, Sweden

2 Sahlgrenska Academy at the University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden

3 Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran

Abstract

Background: Adherence to treatment is a process that begins with alertness about the disease and has to end with staying in treatment. It is a concern to all health care disciplines. The aim of this study was to explore the experience of adherence to treatment patients with chronic diseases.
Methods: This qualitative study was conducted during a period of 6 months in Golestan province in Iran in 2017. In-depth semi-structured interviews were done with a purposive sample of 15 patients with chronic disease (i.e. Chronic renal failure (CRF), Hypertension (HTN), Multiple sclerosis (MS) and Diabetes). Data were analyzed using qualitative content analysis in MAXQDA Software.
Results: The analysis of the data in this study led to the development of ten subthemes and four themes emerged as follows: motivation, cohesion, commitment and empowerment which are necessary components for adherence to treatment in patients. “Moving from alertness to persistence” emerged as the main theme.
Conclusion: The findings of the study offer helpful insights into the concept of adherence to treatment and its components for health care providers, which can be used to develop the best possible care plan and may help health care providers to support the patients to have an active role for following treatment rather than just doing it.

Keywords


  1.  

    1. Lindsay S, Kingsnorth S, Hamdani Y. Barriers and facilitators of chronic illness self-management among adolescents: a review and future directions. Journal of Nursing and Health care of Chronic Illness. 2011;3:186-208.
    2. Seyed*Fatemi N, Rafii F, Hajizadeh E, Modanloo M. Psychometric properties of the adherence questionnaire in patients with chronic disease: A mix method study. Koomesh. 2018;20:179-91. [In Persian]
    3. Jansà M, Hernández C, Vidal M, et al. Multidimensional analysis of treatment adherence in patients with multiple chronic conditions. A cross-sectional study in a tertiary hospital. Patient Education and Counseling. 2010;81:161-8.
    4. Daniali SS, Darani FM, Eslami AA, Mazaheri M. Relationship between Self-efficacy and Physical Activity, Medication Adherence in Chronic Disease Patients. Advanced Biomedical Research. 2017;6:63.
    5. Sahaf R, Ilali ES, Peyrovi H, et al. Uncertainty, the Overbearing Lived Experience of the Elderly People Undergoing Hemodialysis: A Qualitative Study. International Journal of Community Based Nursing and Midwifery. 2017;5:13-21.
    6. Newson JT, Huguet N, Ramage-Morin PL, et al. Health behaviour changes after diagnosis of chronic illness among Canadians aged 50 or older. Health Reports. 2012;23:49-53.
    7. Mirkarimi A, Khoddam H, Vakili MA, et al. Effect of life style modification on adherence to diet and hypertension in hypertensive patients. Koomesh. 2018;20:192-202. [In Persian]
    8. Modanloo M. The challenge of increasing adherence in schizophrenia: Focusing future research on changing attitudes of patients. Asian Journal of Psychiatry. 2018;36:28.
    9. Chiolero A, Burnier M, Santschi V. Improving treatment satisfaction to increase adherence. Journal of Human Hypertension. 2016;30:295-6.
    10. Granger BB, Ekman I, Granger CB, et al. Adherence to medication according to sex and age in the CHARM programme. European Journal of Heart Failure. 2009;11:1092-8.
    11. World Health Organisation. Adherence to long-term therapies: evidence for action. Geneva: World Health Organisation: 2003.
    12. Ashoorkhani M, Majdzadeh R, Gholami J, et al. Understanding Non-Adherence to Treatment in Hypertension: A Qualitative Study. International Journal of Community Based Nursing and Midwifery. 2018;6:314-23.
    13. Rwegerera GM, Moshomo T, Gaenamong M, et al. Antidiabetic medication adherence and associated factors among patients in Botswana; implications for the future. Alexandria Journal of Medicine. 2018;54:103-9.
    14. World Health Organization. Campaign Essentials, World Health Day 2013, Control your blood pressure. Geneva:World Health Organization; 2013.
    15. Mills KT, Bundy JD, Kelly TN, et al. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-based Studies From 90 Countries. Circulation. 2016;134:441-50.
    16. Saarti S, Hajj A, Karam L, et al. Association between adherence, treatment satisfaction and illness perception in hypertensive patients. Journal of Human Hypertension. 2016;30:341-5.
    17. Urbinati S, Olivari Z, Gonzini L, et al. Secondary prevention after acute myocardial infarction: drug adherence, treatment goals, and predictors of health lifestyle habits. The BLITZ-4 Registry. European Journal of Preventive Cardiology. 2015;22:1548-56.
    18. Fina*Lubaki J-P, Mabuza L, Malete N, et al. Reasons for non-compliance among patients with hypertension at Vanga Hospital, Bandundu Province, Democratic Republic of Congo: A qualitative study. African Journal of Primary Health Care & Family Medicine. 2009;1:107-11.
    19. Rafii F, SeyedFatemi N, Danielson E, et al. Compliance to treatment in patients with chronic illness: a concept exploration. Iranian Journal of Nursing and Midwifery Research. 2014;19:159-67.
    20. Brett J, Fenlon D, Boulton M, et al. Factors associated with intentional and unintentional non-adherence to adjuvant endocrine therapy following breast cancer. European Journal of Cancer Care. 2018;27(1).
    21. Pamboukian SV, Nisar I, Patel S, et al. Factors Associated with Non-adherence to Therapy with Warfarin in a Population of Chronic Heart Failure Patients. Clinical Cardiology. 2008;31:30-4.
    22. Van*Hecke A, Grypdonck M, Defloor T. Interventions to enhance patient compliance with leg ulcer treatment: a review of the literature. Journal of Clinical Nursing. 2008;17:29-39.
    23. Paterson BL, Charlton P, Richard S. Non-attendance in chronic disease clinics: a matter of non-compliance? Journal of Nursing and Health care of Chronic Illness. 2010;2:63-74.
    24. Woodgate RL, Zurba M, Tennent P. Advancing patient engagement: youth and family participation in health research communities of practice. Research Involvement and Engagement. 2018;4:9.
    25. De*Vente J, Reed MS, Stringer LC, et al. How does the context and design of participatory decision making processes affect their outcomes? Evidence from sustainable land management in global drylands. Ecology and Society. 2016;21:24.
    26. Fumagalli LP, Radaelli G, Lettieri E, et al. Patient Empowerment and its neighbours: Clarifying the boundaries and their mutual relationships. Health Policy. 2015;119:384-94.
    27. Bissonnette JM. Adherence: a concept analysis. Journal of Advanced Nursing. 2008;63:634-43.
    28. Er V, Lane JA, Martin RM, et al. Barriers and facilitators to healthy lifestyle and acceptability of a dietary and physical activity intervention among African Caribbean prostate cancer survivors in the UK: a qualitative study. BMJ Open. 2017;7:e017217.