White, S, Bissell, P and Anderson, C (2013) A qualitative study of cardiac rehabilitation patients' perspectives on taking medicines: implications for the 'medicines-resistance' model of medicine-taking. BMC Health Services Research, 13. 302 -?. ISSN 1472-6963

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A qualitative study of cardiac rehabilitation patients' perspectives on taking medicines: implications for the 'medicines-resistance' model of medicine-taking.pdf

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BACKGROUND: The appropriate use of medicines continues to be an important area of inter-disciplinary research activity both in the UK and beyond. Key qualitative work in this area in the last decade has included the 'medicines resistance' model of medicine-taking, which was based on a meta-ethnography of 37 qualitative studies. This model proposed that patients approach medicine-taking as 'passive accepters', 'active accepters', 'active modifiers' or 'complete rejecters', of which the latter two categories were considered to show 'resistance' to medicines. However, critical assessment of the model appears to be currently lacking, particularly in terms of its use in clinical practice. This paper seeks to contribute to the literature in this area by critically examining the practical application of the model in light of the findings from a qualitative, follow-up study of cardiac rehabilitation patients' perspectives and experiences of using medicines. METHODS: Following ethical approval, in-depth, audiotaped, qualitative interviews were conducted with fifteen patients who had completed a UK hospital-based cardiac rehabilitation programme. Participants were aged 42-65, white British and from a variety of socioeconomic backgrounds. Interview topics included perspectives on coronary heart disease, medicine-taking and lifestyle changes. Follow-up interviews with ten patients approximately nine months later explored whether their perspectives had changed. RESULTS: The findings suggest that the active/passive and accepter/modifier distinctions may not allow for clear determination of which profile a patient fits into at any given point, and that definitions such as 'accepter' and 'resistance' may be insufficiently discerning to categorise patients' use of medicines in practice. These problems appear to arise when the issue of patients' accounts about medicines adherence are considered, since patients may have concerns or disquiet about medicines whether or not they are adherent and the model does not consider disquiet in isolation from adherence. CONCLUSIONS: Practical application of the 'medicines resistance' model of medicine-taking may be problematic in this patient group. Dissociation of disquiet about medicines from medicines adherence may allow for a focus on helping patients to resolve their disquiet, if possible, without this necessarily having to be viewed in terms of its potential effect on adherence.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via BioMed Central at http://dx.doi.org/10.1186/1472-6963-13-302 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Adult, Attitude to Health, coronary Disease, England, Female, Humans, Male, Medication Adherence, Middle Aged Models Psychological, Qualitative Research, United Kingdom
Subjects: R Medicine > RS Pharmacy and materia medica
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy
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Depositing User: Symplectic
Date Deposited: 06 Jun 2018 13:01
Last Modified: 06 Jun 2018 13:06
URI: https://eprints.keele.ac.uk/id/eprint/4987

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