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Why don’t patients take their analgesics? A meta-ethnography assessing the perceptions of medication adherence in patients with osteoarthritis

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Abstract

Whilst analgesics and medications have demonstrated efficacy for people with osteoarthritis, their effectiveness is dependent on adherence. This has previously been reported as particularly low in this population. The purpose of this meta-ethnography was to explore possible perceptions for this. A systematic review of published and unpublished literature was undertaken. All qualitative studies assessing the attitudes or perceptions of people with osteoarthritis towards medication adherence were eligible. Study quality was assessed using the Critical Appraisal Skills Programme qualitative tool. Analysis was undertaken using a meta-ethnography approach, distilling to a third-order construct and developing a line of argument. From 881 citations, five studies met the eligibility criteria. The meta-ethnography generated a model where medication adherence for people with osteoarthritis is perceived as a balance between the willingness and preference to take medications with the alterative being toleration of symptoms. Motivators to influence this ‘balance’ may fluctuate and change over time but include: severity of symptoms, education and understanding of osteoarthritis and current medications, or general health which may raise issues for poly-pharmacy as other medications are added or substituted into the patient’s formulary. Medicine adherence in people with osteoarthritis is complex, involving motivators which will fluctuate in impact on individuals at different points along the disease progression. Awareness of each motivator may better inform clinicians as to what education, support or change in prescription practice should be adopted to ensure that medicine adherence is individualised to better promote long-term behaviour change.

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Funding

This study was supported by the South Norfolk Clinical Commissioning Group (SNCCG), through Research Capacity Funding (R201396) supporting the lead researcher (TD). The SNCCG did not have a role in the conduct of this research or preparation of this paper.

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Authors and Affiliations

  1. University of East Anglia, Norwich, UK

    T. Dockerty

  2. St George’s Hospital, London, UK

    S. K. Latham

  3. Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Queen’s Building, Norwich Research Park, Norwich, NR4 7TJ, UK

    T. O. Smith

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  1. T. Dockerty
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  2. S. K. Latham
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  3. T. O. Smith
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Correspondence to T. O. Smith.

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Dockerty, T., Latham, S.K. & Smith, T.O. Why don’t patients take their analgesics? A meta-ethnography assessing the perceptions of medication adherence in patients with osteoarthritis. Rheumatol Int 36, 731–739 (2016). https://doi.org/10.1007/s00296-016-3457-8

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  • DOI: https://doi.org/10.1007/s00296-016-3457-8

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