Background

People who take medications often experience challenges including making decisions about risks versus benefits and integrating medication management with all aspects of life (e.g., social and work responsibilities). Existing medication self-management frameworks are primarily adherence-focused and lack integrating holistic perspectives.

Objective

To explore the priorities of people with chronic medication experience (i.e., take at least 1 medication daily for at least 3 months) and what they can contribute to the understanding of medication self-management.

Methods

Concept mapping is a participatory, mixed-methods approach with 3 stages: brainstorming, sorting/rating, and mapping. Group brainstorming discussions were held with participants who generated statements about what mattered to them regarding medications in their everyday lives. In sorting/rating, individual participants grouped statements into thematic piles and rated their importance and feasibility. During mapping, a subset of participants discussed and agreed on a visual map and named the statement clusters. Following mapping, the researchers analyzed rating results, stratified by participant characteristics (gender, age, duration of medication use, number of medications, and chronic conditions).

Results

Sixty-three participants generated 1044 statements during 8 brainstorming sessions, which the researchers synthesized into 94 statements. Fifty-four participants individually sorted and rated the statements. Most statements were rated highly on both importance and feasibility, regardless of participant characteristics. Eight participants attended the mapping session. The final map had 9 thematic clusters, which were named by participants as: 1) researching and becoming educated about medications; 2) social support; 3) effectiveness of medication; 4) self-ownership of medication; 5) ease of use; 6) convenience and accessibility; 7) information provided by healthcare provider; 8) personal interactions with healthcare provider; and 9) patient involvement and trust.

Conclusions

Results enhance existing medication management frameworks by providing a more comprehensive perspective. Understanding medication self-management requires more research that incorporates and prioritizes the perspectives of individuals who manage their medications.

中文翻译：

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探索有慢性药物治疗经验的社区成年人的药物自我管理：概念图研究

背景

服用药物的人经常遇到挑战，包括做出风险与收益的决定以及将药物管理与生活的各个方面（例如，社会和工作责任）相结合。现有的药物自我管理框架主要以依从性为重点，缺乏整合的整体观点。

客观的

探索有长期用药经验的人的优先事项（即每天至少服用 1 种药物，持续至少 3 个月）以及他们对药物自我管理的理解有何贡献。

方法

概念图是一种参与式、混合方法的方法，分为三个阶段：头脑风暴、分类/评级和绘图。与参与者进行了集体头脑风暴讨论，参与者就日常生活中药物的重要性发表了声明。在分类/评级中，个别参与者将陈述分组到主题堆中，并评估它们的重要性和可行性。在映射过程中，一部分参与者讨论并就可视化地图达成一致，并命名声明集群。在映射之后，研究人员分析了按参与者特征（性别、年龄、药物使用时间、药物数量和慢性病）分层的评分结果。

结果

63 名参与者在 8 次头脑风暴会议期间产生了 1044 条陈述，研究人员将这些陈述合成为 94 条陈述。54 名参与者分别对这些陈述进行分类和评分。无论参与者的特征如何，大多数陈述的重要性和可行性都得到了很高的评价。八名参与者参加了测绘会议。最终地图有 9 个主题集群，参与者将其命名为：1）研究和接受药物教育；2) 社会支持；3）药物的有效性；4）药品的自有所有权；5) 易用性；6) 便利性和可访问性；7) 医疗保健提供者提供的信息；8) 与医疗保健提供者的个人互动；9) 患者的参与和信任。

结论

结果通过提供更全面的视角来增强现有的药物管理框架。了解药物自我管理需要更多的研究，纳入并优先考虑管理药物的个人的观点。