Home Care Patients’ Experiences with Home Care Nurses’ Support in Medication Adherence

Abstract

Purpose To describe nurses’ support interventions for medication adherence, and patients’ experiences and desired improvements with this care. Patients and Methods A two-phase study was performed, including an analysis of questionnaire data and conducted interviews with members of the care panel of the Netherlands Patients Federation. The questionnaire assessed 14 types of interventions, satisfaction (score 0–10) with received interventions, needs, experiences, and desired improvements in nurses’ support. Interviews further explored experiences and improvements. Data were analyzed using descriptive statistics and a thematic analysis approach. Results Fifty-nine participants completed the questionnaire, and 14 of the 59 participants were interviewed. The satisfaction score for interventions was 7.9 (IQR 7–9). The most common interventions were: “noticing when I don’t take medication as prescribed” (n = 35), “helping me to find solutions to overcome problems with using medications” (n = 32), “helping me with taking medication” (n = 32), and “explaining the importance of taking medication at the right moment” (n = 32). Fifteen participants missed ≥1 of the 14 interventions. Most mentioned the following: “regularly asking about potential problems with medication use” (33%), “regularly discussing whether using medication is going well” (29%), and “explaining the importance of taking medication at the right moment” (27%). Twenty-two participants experienced the following as positive: improved self-management of adequate medication taking, a professional patient–nurse relationship to discuss adherence problems, and nurses’ proactive attitude to arrange practical support for medication use. Thirteen patients experienced the following as negative: insufficient timing of home visits, rushed appearance of nurses, and insufficient expertise about side effects and taking medication. Suggested improvements included performing home visits on time, more time for providing support in medication use, and more expertise about side effects and administering medication. Conclusion Overall, participants were satisfied, and few participants wanted more interventions. Nurses’ support improved participants’ self-management of medication taking and enabled patients to discuss their adherence problems. Adequately timed home visits, more time for support, and accurate medication-related knowledge are desired.

Effects of a multidisciplinary management program on symptom burden and medication adherence in heart failure patients with comorbidities: A randomized controlled trial

“…These results reflect those of Dijkstra et al (2021), who also found that supportive nursing interventions positively affect medication adherence. In this qualitative study, the participants were satisfied with the intended intervention but wanted to receive more services [40]. Also, These results are consistent with data obtained in Gwadry-sridhar et al 2016) also investigated the effect of a multidisciplinary self-care management program on the adherence of renal patients to antihypertensive treatment, and they reached the same results as the present study [42].…”

“…These results reflect those of Dijkstra et al (2021), who also found that supportive nursing interventions positively affect medication adherence. In this qualitative study, the participants were satisfied with the intended intervention but wanted to receive more services [ 40 ]. Also, These results are consistent with data obtained in Gwadry-sridhar et al (2005) and Heloue et al(2016).…”

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“…The medication management patterns of one-third of the sample potentially increased their risks of an MRP (using potentially inappropriate medicines, drug-drug interactions, hospitalisation) by self-treatment with unprescribed over-the-counter medication, as previously reported by Jin 38 . Most of our home-dwelling older adults were polymedicated but nevertheless managed their medication without regular support from informal or professional caregivers, although this increases the risks of errors, compliance issues and suboptimal medication management 39 . Our ndings showed that one-fth of the sample presented with moderate cognitive impairment, often associated with an increased risk of non-adherence, which can lead to poor therapeutic outcomes, greater risks of MRPs and poor medication management, as reported in the systematic review by Kröger 40 .…”

Patient Satisfaction with a Dedicated Infusion Pump for Subcutaneous Treprostinil to Treat Pulmonary Arterial Hypertension

“…Nevertheless, patients with chronic conditions report higher adherence and persistence with treatment, confident self-management, and lower total costs with nurse support, medication reminders, injection training, and pen disposal [ 16 ]. Moreover, nurse support improves patient self-management of treatment recommendations and enables patients to discuss their adherence problems with healthcare [ 17 ].…”