Östbring Malin Johansson, Hellström Lina, Mårtensson Jan
Pharmaceutical Department Region Kalmar County, Kalmar, Sweden.
eHealth Institute, Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
Patient Prefer Adherence. 2020 Feb 27;14:411-424. doi: 10.2147/PPA.S230120. eCollection 2020.
Living with coronary heart disease (CHD) usually means being prescribed several medications to help prevent new cardiac events. Using medicines for long-term conditions impacts on day-to-day life, and coping with medicines can be burdensome and can affect the quality of life. To enable better support of these patients, we need to understand their collective medicine-related experience.
The purpose of this study was to describe patients' medicine-related experience 1 year after the diagnosis of CHD.
A qualitative, descriptive study using semi-structured interviews was conducted in 19 patients in their homes or at Linnaeus University, Sweden. Interviews were recorded and transcribed verbatim. Qualitative content analysis with an inductive approach was used.
Patients' experiences with using their medicines after diagnosis of CHD differed considerably. Some patients found handling the medicines and administering their treatment very easy, natural and straightforward, while others found that it was distressing or troublesome, and influenced their lives extensively. There was a varied sense of personal responsibility about the treatment and use of medicines. The patients' experiences were classified into one of seven categories: a sense of security, unproblematic, learning to live with it, taking responsibility for it, somewhat uncertain, troublesome, or distressing. Participants in the study who expressed an unproblematic view of medicine taking also often revealed that they had dilemmas or uncertainties.
Patients' medicine-related experiences after CHD vary greatly. The findings of this study highlight a need for more individualized support for patients using medicines for secondary prevention. The patients often needed better dialogue with healthcare providers to optimally manage their medicines. Medicine-related support for these patients should encompass various aspects of medicine-taking.
患有冠心病（CHD）通常意味着需要服用多种药物来预防新的心脏事件。长期使用药物会影响日常生活，应对药物治疗可能会很繁琐，并会影响生活质量。为了能更好地支持这些患者，我们需要了解他们与药物相关的总体经历。
本研究的目的是描述冠心病诊断后1年患者与药物相关的经历。
采用半结构式访谈进行了一项定性描述性研究，研究对象为瑞典林奈大学或其家中的19名患者。访谈进行了录音并逐字转录。采用归纳法进行定性内容分析。
冠心病诊断后患者使用药物的经历差异很大。一些患者觉得处理药物和进行治疗非常容易、自然且直接，而另一些患者则觉得这令人痛苦或麻烦，并对他们的生活产生了广泛影响。患者对治疗和药物使用的个人责任感各不相同。患者的经历被分为七类之一：安全感、没问题、学会适应、承担责任、有些不确定、麻烦或痛苦。研究中对服药持没问题看法的参与者也常常表示他们存在困境或不确定性。
冠心病患者与药物相关的经历差异很大。本研究结果凸显了对使用药物进行二级预防的患者需要提供更个性化支持的必要性。患者通常需要与医疗服务提供者进行更好的沟通，以优化药物管理。对这些患者的药物相关支持应涵盖服药的各个方面。
