Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery: a qualitative study based on Protection Motivation Theory
Objectives This study aims to identify factors influencing medication adherence for deep vein thrombosis (DVT) prophylaxis in post-discharge patients after joint replacement surgery using Protection Motivation Theory (PMT).Design This study employed qualitative semi-structured interviews with patien...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/5/e090983.full |
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| author | Jing Jiang Jing Zhang Chao Liu Lingyun Tian Yinglan Li Feng Fu Wenchao Gu Leijiang Li Xiurui Deng |
| author_facet | Jing Jiang Jing Zhang Chao Liu Lingyun Tian Yinglan Li Feng Fu Wenchao Gu Leijiang Li Xiurui Deng |
| author_sort | Jing Jiang |
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| description | Objectives This study aims to identify factors influencing medication adherence for deep vein thrombosis (DVT) prophylaxis in post-discharge patients after joint replacement surgery using Protection Motivation Theory (PMT).Design This study employed qualitative semi-structured interviews with patients discharged after hip or knee replacement surgery.Setting Using purposive sampling to ensure a diverse representation of patient profiles, participants were recruited from patients who underwent total knee replacement surgery from April 2024 to May 2024 and were discharged 1-month prior.Participants 12 patients who had undergone total knee replacement surgery participated in the study. The median (IQR) age of participants was 57.5 (55–67.25) years.Analysis Semi-structured interviews were conducted via online video calls. These interviews were audio recorded and transcribed verbatim. Data were analysed using Colaizzi’s seven-step method. Themes were identified based on the dimensions of the PMT: susceptibility, severity, internal rewards, external rewards, response efficacy, self-efficacy and response costs. Two researchers independently coded and extracted themes, with discrepancies resolved through team discussions and verification with respondents.Results Participants acknowledged the importance of adhering to anticoagulant medication to prevent DVT and its complications, understanding the severe consequences, such as the life-threatening nature of pulmonary embolism and the impact on daily activities. Perceived health status influenced adherence, with some participants feeling their good health negated the need for anticoagulants. External factors, including the desire to avoid side effects and financial constraints, also played significant roles in adherence decisions. Belief in the effectiveness of anticoagulants motivated adherence, but confidence in managing medication varied among participants. Practical barriers such as physical limitations and psychological burdens significantly impacted adherence.Conclusions Improving medication adherence requires a multifaceted approach addressing cognitive, motivational and practical barriers. Continuous education, financial assistance, support systems and tailored interventions are crucial. PMT provides a robust framework for understanding and enhancing adherence behaviours, ultimately improving health outcomes in post-discharge joint replacement patients. |
| format | Article |
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| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-3bc1642df94d454cb0f6aa510ea0c19a2025-08-20T02:15:30ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2024-090983Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery: a qualitative study based on Protection Motivation TheoryJing Jiang0Jing Zhang1Chao Liu2Lingyun Tian3Yinglan Li4Feng Fu5Wenchao Gu6Leijiang Li7Xiurui Deng8Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, Hunan Province, 410013, ChinaDepartment of Orthopedics, the Fourth Affiliated Hospital of Xinjiang Medical University, 116 Huanghe Road, Urumqi, Xinjiang Uygur Autonomous Region, 830000, ChinaNursing Department of Xinjiang Medical University, 567 Shangde North Road, Urumgi, Xinjiang Uygur Autonomous Region, 830000, ChinaDepartment of Nursing, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, ChinaTeaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha, Hunan Province, 410008, ChinaNursing Department of Xinjiang Medical University, 567 Shangde North Road, Urumgi, Xinjiang Uygur Autonomous Region, 830000, ChinaDepartment of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, 137 Liyushan South Road, Urumqi, Xinjiang Uygur Autonomous Region, 830000, ChinaDepartment of Orthopedics, the Fourth Affiliated Hospital of Xinjiang Medical University, 116 Huanghe Road, Urumqi, Xinjiang Uygur Autonomous Region, 830000, ChinaNursing Department of Xinjiang Medical University, 567 Shangde North Road, Urumgi, Xinjiang Uygur Autonomous Region, 830000, ChinaObjectives This study aims to identify factors influencing medication adherence for deep vein thrombosis (DVT) prophylaxis in post-discharge patients after joint replacement surgery using Protection Motivation Theory (PMT).Design This study employed qualitative semi-structured interviews with patients discharged after hip or knee replacement surgery.Setting Using purposive sampling to ensure a diverse representation of patient profiles, participants were recruited from patients who underwent total knee replacement surgery from April 2024 to May 2024 and were discharged 1-month prior.Participants 12 patients who had undergone total knee replacement surgery participated in the study. The median (IQR) age of participants was 57.5 (55–67.25) years.Analysis Semi-structured interviews were conducted via online video calls. These interviews were audio recorded and transcribed verbatim. Data were analysed using Colaizzi’s seven-step method. Themes were identified based on the dimensions of the PMT: susceptibility, severity, internal rewards, external rewards, response efficacy, self-efficacy and response costs. Two researchers independently coded and extracted themes, with discrepancies resolved through team discussions and verification with respondents.Results Participants acknowledged the importance of adhering to anticoagulant medication to prevent DVT and its complications, understanding the severe consequences, such as the life-threatening nature of pulmonary embolism and the impact on daily activities. Perceived health status influenced adherence, with some participants feeling their good health negated the need for anticoagulants. External factors, including the desire to avoid side effects and financial constraints, also played significant roles in adherence decisions. Belief in the effectiveness of anticoagulants motivated adherence, but confidence in managing medication varied among participants. Practical barriers such as physical limitations and psychological burdens significantly impacted adherence.Conclusions Improving medication adherence requires a multifaceted approach addressing cognitive, motivational and practical barriers. Continuous education, financial assistance, support systems and tailored interventions are crucial. PMT provides a robust framework for understanding and enhancing adherence behaviours, ultimately improving health outcomes in post-discharge joint replacement patients.https://bmjopen.bmj.com/content/15/5/e090983.full |
| spellingShingle | Jing Jiang Jing Zhang Chao Liu Lingyun Tian Yinglan Li Feng Fu Wenchao Gu Leijiang Li Xiurui Deng Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery: a qualitative study based on Protection Motivation Theory BMJ Open |
| title | Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery: a qualitative study based on Protection Motivation Theory |
| title_full | Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery: a qualitative study based on Protection Motivation Theory |
| title_fullStr | Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery: a qualitative study based on Protection Motivation Theory |
| title_full_unstemmed | Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery: a qualitative study based on Protection Motivation Theory |
| title_short | Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery: a qualitative study based on Protection Motivation Theory |
| title_sort | factors influencing medication adherence for deep vein thrombosis prevention in post discharge patients after joint replacement surgery a qualitative study based on protection motivation theory |
| url | https://bmjopen.bmj.com/content/15/5/e090983.full |
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