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:: Volume 19, Number 6 (Iranian South Medical Journal 2017) ::
Iran South Med J 2017, 19(6): 989-1004 Back to browse issues page
The Challenge of Adherence From Treatment-Care Regimens Among Patients With Chronic Diseases: A Qualitative Study
Hakemeh Vahedparast1, Esae Mohammadi *2, Fazllolah Ahmadi3
1- Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
Department of Nursing, School of Medical Sciences, Tarbiat Modares University Tehran, Iran
2- Department of Nursing, School of Medical Sciences, Tarbiat Modares University Tehran, Iran , mohamade@modares.ac.ir
3- Department of Nursing, School of Medical Sciences, Tarbiat Modares University Tehran, Iran
Abstract:   (1548 Views)

Background: Adherence from treatment-care regimens is very essential to achieve health promotion and improve quality of life as well as affordable healthcare. Nevertheless, broaden of chronic diseases is still growing in the world because of lack of adherence. Understanding the perceived challenges can facilitate planning to increase adherence. This study aimed to explain the perceived challenges in non-adherence from the prescribed regimen among patients with chronic diseases.

Materials and methods: This qualitative study was done in 2015 by using the conventional content analysis approach. Thirty four participants with the most common chronic diseases were recruited purposively and they were entered in the study. Data was collected through semi-structured interviews and simultaneously with data collection; a comparative analysis was conducted by using the conventional qualitative content analysis method.

Results: Four main themes extracted from the data included: flaw in the possibility of observing the recommended regimensafter  devotion for family; frustration in facing the conflict between work and recommended regimens; inability in self-adaption with the recommended regimens; broaden cost of prescribed regimens; and limiting and inductive enclosure of beliefs. These themes indicate the nature of challenges in personal, family, and social dimensions of patients with chronic diseases in terms of adherence with treatment regimen.

Conclusion: The findings show that the perceived challenges has special complexity and diversity. Although they are sometimes internal and personal, some others are external and beyound the will and control of individuals. Therefore, it is necessary that health system policy-makers and planners intervene and plan according to the nature, diversity, and complexity of these perceived barriers in order to facilitate in the adherence of patients process from the treatment care regimens.

Keywords: Adherence, Chronic diseases, Perceived Barriers, Treatment regimens, Qualitative Study
Full-Text [PDF 535 kb]   (353 Downloads)    
Subject: Public Health
Received: 2016/12/27 | Accepted: 2016/12/27 | Published: 2016/12/27
References
1. Venugopal R, Narasimha Murthy NS, Gopinath D. Factors influencing compliance to treatment among people with chronic illness in an urban area of South India. Int J Biol Med Res 2012; 3(2): 1495-7. [Google Scholar]
2. van Houtum L, Rijken M, Heijmans M, et al. Patient-perceived self-management tasks and support needs of people with chronic illness: generic or disease specific. Ann Behav Med 2015; 49(2): 221-9. [PubMed] [Google Scholar]
3. Fort MP, Alvarado-Molina N, Peña L, et al. Barriers and facilitating factors for disease self-management: a qualitative analysis of perceptions of patients receiving care for type 2 diabetes and/or hypertension in San José, Costa Rica and Tuxtla Gutiérrez, Mexico. BMC Fam Pract 2013; 14: 131. [PubMed] [Google Scholar]
4. Sharaf F, Midhet F, Al-Mohaimeed A. Comparative study of compliance between hospital and primary care diabetic patients. Public Health Res 2012; 2(6): 197-203. [Google Scholar]
5. Murray J, Fenton G, Honey S, et al. A qualitative synthesis of factors influencing maintenance of lifestyle behaviour change in individuals with high cardiovascular risk. BMC Cardiovasc Disord 2013; 13: 48. [PubMed] [Google Scholar]
6. D'Addario M, Cappelletti E, Sarini M, et al. Communication and disease management: a qualitative study on coronary disease. Health Psychol Behav Med 2015; 3(1): 94-108. [Google Scholar]
7. Campbell DJ, Ronksley PE, Manns BJ, et al. The association of income with health behavior change and disease monitoring among patients with chronic disease. PLoS One 2014; 9(4): e94007. [PubMed] [Google Scholar]
8. Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. J Diabetes Metab Disord 2013; 12(1): 14. [PubMed] [Google Scholar]
9. Sarayani A, Jahangard-Rafsanjani Z, Hadjibabaie M, et al. A comprehensive review of adherence to diabetes and cardiovascular medications in Iran; implications for practice and research. J Diabetes Metab Disord 2013; 12(1): 57. [PubMed] [Google Scholar]
10. Al Hamid A, Ghaleb M, Aljadhey H, et al. A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus. BMJ Open 2014; 4(9): e005992. [PubMed] [Google Scholar]
11. Li Y, Owen T, Thimbleby H, et al. A design to empower patients in long term wellbeing monitoring and chronic disease management in mHealth. Stud Health Technol Inform 2013; 194: 82-7. [Google Scholar]
12. Marshall IJ, Wolfe CD, McKevitt C. Lay perspectives on hypertension and drug adherence: systematic review of qualitative research. BMJ 2012; 345: e3953. [PubMed] [Google Scholar]
13. Lucas A, Murray E, Kinra S. Heath beliefs of UK South Asians related to lifestyle diseases: a review of qualitative literature. J Obes 2013; 201: 827674. [PubMed] [Google Scholar]
14. Manoochehri H, Lolaty HA, Hassani P, et al. Non-Traditional Roles of Iranian Senior Nurse Managers in Developing the Profession:A Qualitative Study. IJCBNM 2013; 1(4): 191-9. [Google Scholar]
15. Latifi Rastian M, Borzabady Farahani Z, Rasouli M, et al. The effect of nursing process implementation on nursing care quality in surgical wards. J Shahid Beheshti School Nurs Midwifery 2015; 24(87): 29-36. (Persian) [Google Scholar]
16. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24(2): 105-12. [PubMed] [Google Scholar]
17. Anney VN. Ensuring the quality of the findings of qualitative research: looking at Trustworthiness Criteria. J Edu Res Policy Studi 2014; 5(2): 274-81. [Google Scholar]
18. Bayliss EA, Steiner JF, Fernald DH, et al. Descriptions of barriers to self-care by persons with comorbid chronic diseases. Ann Fam Med 2003; 1(1): 15-21. [PubMed] [Google Scholar]
19. Gellad WF, Grenard JL, Marcum ZA. A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity. Am J Geriatr Pharmacother 2011; 9(1): 11-23. [PubMed] [Google Scholar]
20. Pourghane P, Hosseini M, Mohammadi F, et al. Living Within Limits: Unpleasant Experiences From the Perspective of Patients After Cardiac Surgery, a Content Analysis Study. Jundishapur J Chronic Disease Care 2014; 3(3): e21704. [Google Scholar]
21. Siabani S, Leeder SR, Davidson PM. Barriers and facilitators to self-care in chronic heart failure: a meta-synthesis of qualitative studies. Springerplus 2013; 2: 320. [PubMed] [Google Scholar]
22. Murphy K, Chuma T, Mathews C, et al. A qualitative study of the experiences of care and motivation for effective self-management among diabetic and hypertensive patients attending public sector primary health care services in South Africa. BMC Health Serv Res 2015; 15: 303. [PubMed] [Google Scholar]
23. Anastasios Tzenalis RN. Diabetic patients’ compliance to the recommended treatment: A qualitative study in Greece. IJCS 2011; 4(3): 126-32. [Google Scholar]
24. Chlebowy DO, Hood S, LaJoie AS. Facilitators and barriers to self-management of type 2 diabetes among urban African American adults focus group findings. Diabetes Educ 2010; 36(6): 897-905. [PubMed] [Google Scholar]
25. Keshani P, Farvid MS. Perceived benefits and barriers regarding high fiber food intake in type 2 diabetes patients- A qualitative study. Iranian J Nutrition Sci Food Technol 2012; 7(1): 11-22. [Google Scholar]
26. Frohlich DO. The social support model for people with chronic health conditions: A proposal for future research. Social Theory Health 2014; 12(2): 218-34. [Google Scholar]
27. Tong WT, Vethakkan SR, Ng CJ. Why do some people with type 2 diabetes who are using insulin have poor glycaemic control? A qualitative study. BMJ Open 2015; 5(1): e006407. [PubMed] [Google Scholar]
28. Jin J, Sklar GE, Min Sen Oh V, et al. Factors affecting therapeutic compliance: A review from the patient’s perspective. Ther Clin Risk Manag 2008; 4(1): 269-86. [PubMed] [Google Scholar]
29. Peyrot M, Barnett AH, Meneghini LF, et al. Insulin adherence behaviours and barriers in the multinational Global Attitudes of Patients and Physicians in Insulin Therapy study. Diabet Med 2012; 29(5): 682-9. [PubMed] [Google Scholar]
30. Jeragh-Alhaddad FB, Waheedi M, Barber ND, et al. Barriers to medication taking among Kuwaiti patients with type 2 diabetes: a qualitative study. Patient Prefer Adherence 2015; 9: 1491-503. [PubMed] [Google Scholar]
31. Ganiyu AB, Mabuza LH, Malete NH, et al. Non-adherence to diet and exercise recommendations amongst patients with type 2 diabetes mellitus attending Extension II Clinic in Botswana. Afr J Prm Health Care Fam Med 2013; 5(1): 1-6. [Google Scholar]
32. Endevelt R, Gesser-Edelsburg A. A qualitative study of adherence to nutritional treatment: perspectives of patients and dietitians. Patient Prefer Adherence 2014; 8: 147-54. [PubMed] [Google Scholar]
33. Tripp-Reimer T, Choi E, Kelley LS, et al. Cultural barriers to care: inverting the problem. Diabetes Spectrum 2001; 14(1): 13-22. [Google Scholar]
34. Oli N, Vaidya A, Subedi M, et al. Experiences and perceptions about cause and prevention of cardiovascular disease among people with cardiometabolic conditions: findings of in-depth interviews from a peri-urban Nepalese community. Glob Health Action 2014; 7: 1-11. [PubMed] [Google Scholar]
35. Kelley JA, Sherrod RA, Smyth P. Coronary artery disease and smoking cessation intervention by primary care providers in a rural clinic. Online J Rural Nursing Health Care 2012; 9(2): 82-94. [Google Scholar]
36. Martin LR, Williams SL, Haskard KB, et al. The challenge of patient adherence. Ther Clin Risk Manag 2005; 1(3): 189-199. [PubMed] [Google Scholar]
37. Heydari A, Ziaee ES, Gazrani A. Relationship between Awareness of Disease and Adherence to Therapeutic Regimen among Cardiac Patients. Int J Community Based Nurs Midwifery 2015; 3(1): 23-30. [PubMed] [Google Scholar]
38. Meyer SB, Coveney J, Ward PR. A qualitative study of CVD management and dietary changes: problems of ‘too much’ and contradictory information. BMC Fam Pract 2014; 15: 25. [PubMed] [Google Scholar]
39. Lawton J, Ahmad N, Hanna L, et al. ‘I can’t do any serious exercise’: barriers to physical activity amongst people of Pakistani and Indian origin with type 2 diabetes. Health Educ Res 2006; 21(1): 43-54. [PubMed] [Google Scholar]
40. Fürthauer J, Flamm M, Sönnichsen A. Patient and physician related factors of adherence to evidence based guidelines in diabetes mellitus type, cardiovascular disease and prevention: a cross sectional study. BMC Fam Pract 2013; 14: 47. [PubMed] [Google Scholar]
41. Bauler S, Jacquin-Courtois S, Haesebaert J, et al. Barriers and facilitators for medication adherence in stroke patients: a qualitative study conducted in French neurological rehabilitation units. Eur Neurol 2014; 72(5-6): 262-70. [PubMed] [Google Scholar]
42. Jeragh-Alhaddad FB, Waheedi M, Barber ND, et al. Barriers to medication taking among Kuwaiti patients with type 2 diabetes: a qualitative study. Patient Prefer Adherence 2015; 9: 1491-503. [PubMed] [Google Scholar]
43. Barnes L, Moss-Morris R, Kaufusi M. Illness beliefs and adherence in diabetes mellitus: a comparison between Tongan and European patients. N Z Med J 2004; 117(1188): U743. [PubMed]
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DOI: 10.18869/acadpub.ismj.19.6.989


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Vahedparast H, Mohammadi E, Ahmadi F. The Challenge of Adherence From Treatment-Care Regimens Among Patients With Chronic Diseases: A Qualitative Study. Iran South Med J. 2017; 19 (6) :989-1004
URL: http://ismj.bpums.ac.ir/article-1-847-en.html
Volume 19, Number 6 (Iranian South Medical Journal 2017) Back to browse issues page
دانشگاه علوم پزشکی بوشهر، طب جنوب ISMJ

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