Medication adherence for persons with spinal cord injury and dysfunction from the perspectives of healthcare providers: A qualitative study

The Journal of Spinal Cord Medicine, 2019 · DOI: 10.1080/10790268.2019.1637644 · Published: January 1, 2019

Spinal Cord Injury Patient Experience Healthcare

Simple Explanation

This study explores the factors influencing medication adherence in individuals with spinal cord injury and dysfunction (SCI/D) from the perspective of healthcare providers. Healthcare providers identified micro-level (medication and patient-related), meso-level (provider-related), and macro-level (health system-related) factors influencing medication adherence. The study highlights the importance of multi-faceted strategies to optimize medication adherence for persons with SCI/D, considering factors at various levels.

Study Duration

9 Months

Participants

32 healthcare providers from Canada

Evidence Level

Level IV, Qualitative Study

Key Findings

1
Micro-level factors, including medication-related factors like side effects and patient-specific factors such as medication knowledge, were most frequently discussed by providers.
2
Meso-level factors, such as provider knowledge/confidence and patient trust, and macro-level factors, including access to healthcare and medications, also influence adherence.
3
Healthcare providers recognized the impact of mental health issues, such as depression and anxiety, on medication adherence in individuals with SCI/D.

Research Summary

This qualitative study explored healthcare providers’ perceptions of factors influencing medication adherence for individuals with spinal cord injury and dysfunction (SCI/D). Providers identified micro-, meso-, and macro-level factors affecting adherence, with micro-level factors being the most frequently discussed. The study emphasizes the need for multi-faceted strategies to optimize medication adherence, considering factors related to medications, patients, providers, and the healthcare system.

Practical Implications

Targeted Interventions

Develop tailored interventions focusing on patient education, medication side effect management, and simplification of medication regimens to address micro-level factors.

Enhance Provider-Patient Relationship

Foster trusting relationships between healthcare providers and patients to improve information sharing and collaborative decision-making regarding medication management.

Improve Healthcare Accessibility

Address systemic barriers to healthcare access, such as transportation, wait times, and funding limitations, to ensure patients can obtain necessary medications and support.

Study Limitations

1
Challenges recruiting diverse specialist physicians, potentially limiting the breadth of perspectives.
2
Most participants were recruited from one province (Ontario), potentially limiting the generalizability to other jurisdictions.
3
Reliance on snowball sampling for physician recruitment may have resulted in a sample with more clinical expertise in SCI/D compared to the general physician population.

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