Social context, the struggle with uncertainty, and subjective risk as meaning-rich constructs for explaining HBP noncompliance.

OBJECTIVE

To identify the reasons for which people fail to take blood-pressure-lowering medication regularly, a qualitative study was conducted.

METHODS

Interviews lasting approximately 90 min were conducted with 27 patients (15 women, 12 men) aged 40-70. The verbatim of the 27 interviews was first read and divided into segments with explanatory value. This was followed by the production of a final text in vignette form for all interviews. An integrative, analytical phase consisted of identifying trends, significant central themes, regularities, and divergences in the vignettes.

RESULTS

Analysis revealed the explanatory power that 3 broad groups of subjective meanings could hold for given medication noncompliance scenarios. These scenarios are expressing the role of: (1) stress and living conditions in the occasional skipping or deferral of medication-taking; (2) doubt as the motivating factor for transitory, irregular medication use; (3) subjective risk as the motivating factor for persistent irregular use.

CONCLUSION

Life and social contexts, doubt and risk subsume extremely meaning-rich constructs that can help identify dilemmas facing people about medication-taking.

PRACTICE IMPLICATIONS

By discussing these dimensions with their patients, health professionals will be better able to understand patient medication behaviors that sometimes run counter to their recommendations.