Smith J C, Seage C H, Lane E, James D H
Department of Applied Psychology, Cardiff School of Health Sciences, Cardiff Metropolitan University, Llandaff Campus, 200 Western Avenue, Cardiff, Wales CF5 2YB, UK.
Cardiff School of Pharmacy & Pharmaceutical Sciences, Cardiff University, King Edward VIIth Avenue, Cardiff, Wales CF10 3NB, UK.
Explor Res Clin Soc Pharm. 2023 Jul 13;11:100309. doi: 10.1016/j.rcsop.2023.100309. eCollection 2023 Sep.
Patient medication adherence in Parkinson's Disease (PD) is often suboptimal. This may lead to poor symptom management, greater disease burden, decreased quality of life and increased healthcare costs. Use of psychological theory such as the Theoretical Domains Framework (TDF) has effectively captured barriers and facilitators to medication adherence in other long-term conditions. Applying this framework to medication adherence in PD could provide a better understanding of the challenges to inform the development of effective interventions.
The aim of the study was to apply the TDF to determine the barriers and facilitators to medication adherence in people with PD.
This qualitative study employed online interviews to explore medication adherence in a small group of people with PD recruited via Parkinson's UK and social media. A semi-structured interview schedule was designed informed by the 14 TDF domains. All interviews were audio-recorded, transcribed verbatim and mapped to the TDF using Framework Analysis.
Twelve participants diagnosed with PD were interviewed, 11 of whom were currently taking prescribed medication plus another self-medicating with Vitamin B1. All TDF domains were evident in the data. Predominant facilitators were Domains 1 - , 6 - , and 12 - and barriers were 7 - , 10 - , and 11 - . Other themes were not related to medication adherence.
In this small group, all data relating to the barriers and facilitators for medication adherence in PD were successfully mapped onto the TDF. This indicates the utility of the framework for determining and structuring the factors to consider when providing medication support for this patient population in an accessible and coherent way. Further quantitative studies are needed to determine the extent to which these factors can be generalised to other PD patients.
帕金森病(PD)患者的药物依从性通常欠佳。这可能导致症状管理不善、疾病负担加重、生活质量下降以及医疗成本增加。运用诸如理论领域框架(TDF)等心理学理论,已有效找出其他慢性病中药物依从性的障碍和促进因素。将该框架应用于PD患者的药物依从性研究,有助于更好地理解相关挑战,从而为有效干预措施的制定提供依据。
本研究旨在应用TDF确定PD患者药物依从性的障碍和促进因素。
本定性研究通过在线访谈,对一小群经英国帕金森病协会和社交媒体招募的PD患者的药物依从性进行了探讨。根据TDF的14个领域设计了半结构化访谈提纲。所有访谈均进行了录音,逐字转录,并使用框架分析法映射到TDF。
对12名被诊断为PD的参与者进行了访谈,其中11人正在服用处方药,另有1人自行服用维生素B1。数据中所有TDF领域均有体现。主要促进因素为领域1 - 、6 - 和12 - ,障碍为7 - 、10 - 和11 - 。其他主题与药物依从性无关。
在这个小群体中,所有与PD患者药物依从性的障碍和促进因素相关的数据都成功映射到了TDF上。这表明该框架在以易懂且连贯的方式为这一患者群体提供药物支持时,对于确定和梳理需要考虑的因素具有实用性。需要进一步开展定量研究,以确定这些因素在多大程度上可推广至其他PD患者。