Key result
Healthcare providers identified micro, meso, and macro-level factors impacting medication adherence in patients with spinal cord injury, with micro-level factors being the most frequently discussed.
Why the study?
Multiple healthcare providers involved in care for spinal cord injury and dysfunction increase risks of fragmented care and problematic polypharmacy, highlighting their role in medication self-management.
What factors impact medication adherence for persons with spinal cord injury and dysfunction from the perspective of healthcare providers?
What factors impact medication adherence for persons with spinal cord injury and dysfunction from the perspective of healthcare providers?
Strategies to optimize medication adherence for persons with spinal cord injury and dysfunction should be multi-faceted, addressing micro, meso, and macro-level factors.
Highlights potential provider role in SCI/D medication adherence; leaves open whether targeted interventions improve outcomes.
Context: People with spinal cord injury and dysfunction (SCI/D) often take multiple medications (i.e. polypharmacy) to manage secondary health complications and multiple chronic conditions. Numerous healthcare providers are often involved in clinical care, increasing the risk of fragmented care, problematic polypharmacy, and conflicting health advice. These providers can play a crucial role in assisting patients with medication self-management to improve medication adherence.Design: A qualitative study involving telephone interviews, following a semi-structured guide that explored healthcare providers' conceptualization of factors impacting medication adherence for persons with SCI/D. The interviews were transcribed and analyzed descriptively and interpretively using a constant comparative process with the assistance of data display matrices. Analysis was guided by an ecological model of medication adherence.Setting and participants: Thirty-two healthcare providers from Canada, with varying clinical expertise.Intervention: Not Applicable.Outcome measures: Not Applicable.Results: Providers identified several factors that impact medication adherence for persons with SCI/D, which were grouped into micro (medication and patient-related), meso- (provider-related) and macro- (health system-related) factors. Medication-related factors included side effects, effectiveness, safety, and regimen complexity. Patient-specific factors included medication knowledge, preferences/expectations/goals, severity and type of injury, cognitive function/mental health, time since injury, and caregiver support. Provider-related factors included knowledge/confidence and trust. Health system-related factors included access to healthcare and access to medications. While providers were able to identify several factors influencing medication adherence, micro-level factors were the most frequently discussed.Conclusion: Findings from this study indicate that strategies to optimize medication adherence for persons with SCI/D should be multi-faceted.
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Guilcher et al. (2019) studied Spinal cord injury and dysfunction (SCI/D) (n=32). Factors impacting medication adherence was evaluated on Factors impacting medication adherence. Healthcare providers identified micro, meso, and macro-level factors impacting medication adherence in patients with spinal cord injury, with micro-level factors being the most frequently discussed.
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