Influencing factors and their relationships of risk perception and decision-making behaviour of polypharmacy in patients with chronic diseases: a qualitative descriptive study

Objectives In order to understand the influencing factors of the medication-taking behaviour in patients with chronic diseases, reveal the deep-seated causes underlying the phenomenon of polypharmacy, explore the formation rules of the risk perception of polypharmacy and how risk perception affect t...

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Main Authors: Jia Wang, Ruoxi Wang, Da Feng, Rui Huang, Yan Cao, Yuxin Liu
Format: Article
Language:English
Published: BMJ Publishing Group 2021-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/4/e043557.full
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author Jia Wang
Ruoxi Wang
Da Feng
Rui Huang
Yan Cao
Yuxin Liu
author_facet Jia Wang
Ruoxi Wang
Da Feng
Rui Huang
Yan Cao
Yuxin Liu
author_sort Jia Wang
collection DOAJ
description Objectives In order to understand the influencing factors of the medication-taking behaviour in patients with chronic diseases, reveal the deep-seated causes underlying the phenomenon of polypharmacy, explore the formation rules of the risk perception of polypharmacy and how risk perception affect the medication decision-making behaviour of patients with chronic diseases.Design A qualitative descriptive design was used. Study data were collected through semi-structured interviews with patients and physicians. We used the grounded theory approach to refine influencing factors, followed by interpretative structural modelling that analysed the interaction between these factors.Setting Patients from two hospitals, two nursing homes and two communities. Physicians from two community hospitals in Wuhan, China.Participants Patients with chronic diseases with high willingness to cooperate and good communication ability. Physicians with rich experience in the treatment of chronic diseases.Results Twenty-nine interviews were conducted (20 patients and 9 physicians). A total of 35 influencing factors of the medication-taking behaviours in patients with chronic diseases were extracted from the interview data, further integrated into 10 integrated influencing factors and ultimately clustered into three aspects: ‘medication benefit’, ‘medication risk’ and ‘medication strategy’. Medication risk can be divided into four specific dimensions: economic risk, physical risk, psychosocial risk and time risk. 10 integrated influencing factors constituted the interpretative structural model of the medication decision-making behaviours in patients with chronic diseases.Conclusions The causes underlying the medication decision-making behaviour of patients with chronic diseases are complex, involving a series of influencing factors such as their risk perception of the medication-taking behaviour. In order to alleviate the adverse effects of polypharmacy on patients’ health and medical costs, further safety measures should be proposed to improve the medication-taking behaviour in patients with chronic diseases based on the relationship and internal mechanism of the influencing factors of the medication decision-making behaviour.
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spelling doaj-art-c1a3b1a1a5584782894313dec6eeedc82025-08-20T02:32:48ZengBMJ Publishing GroupBMJ Open2044-60552021-04-0111410.1136/bmjopen-2020-043557Influencing factors and their relationships of risk perception and decision-making behaviour of polypharmacy in patients with chronic diseases: a qualitative descriptive studyJia Wang0Ruoxi Wang1Da Feng2Rui Huang3Yan Cao4Yuxin Liu5Department of Anesthesiology, Sichuan University West China Hospital, Chengdu, Sichuan, ChinaSchool of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaTongji Medical College, School of Pharmacy, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA6 School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Hubei, ChinaDepartment of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, ChinaObjectives In order to understand the influencing factors of the medication-taking behaviour in patients with chronic diseases, reveal the deep-seated causes underlying the phenomenon of polypharmacy, explore the formation rules of the risk perception of polypharmacy and how risk perception affect the medication decision-making behaviour of patients with chronic diseases.Design A qualitative descriptive design was used. Study data were collected through semi-structured interviews with patients and physicians. We used the grounded theory approach to refine influencing factors, followed by interpretative structural modelling that analysed the interaction between these factors.Setting Patients from two hospitals, two nursing homes and two communities. Physicians from two community hospitals in Wuhan, China.Participants Patients with chronic diseases with high willingness to cooperate and good communication ability. Physicians with rich experience in the treatment of chronic diseases.Results Twenty-nine interviews were conducted (20 patients and 9 physicians). A total of 35 influencing factors of the medication-taking behaviours in patients with chronic diseases were extracted from the interview data, further integrated into 10 integrated influencing factors and ultimately clustered into three aspects: ‘medication benefit’, ‘medication risk’ and ‘medication strategy’. Medication risk can be divided into four specific dimensions: economic risk, physical risk, psychosocial risk and time risk. 10 integrated influencing factors constituted the interpretative structural model of the medication decision-making behaviours in patients with chronic diseases.Conclusions The causes underlying the medication decision-making behaviour of patients with chronic diseases are complex, involving a series of influencing factors such as their risk perception of the medication-taking behaviour. In order to alleviate the adverse effects of polypharmacy on patients’ health and medical costs, further safety measures should be proposed to improve the medication-taking behaviour in patients with chronic diseases based on the relationship and internal mechanism of the influencing factors of the medication decision-making behaviour.https://bmjopen.bmj.com/content/11/4/e043557.full
spellingShingle Jia Wang
Ruoxi Wang
Da Feng
Rui Huang
Yan Cao
Yuxin Liu
Influencing factors and their relationships of risk perception and decision-making behaviour of polypharmacy in patients with chronic diseases: a qualitative descriptive study
BMJ Open
title Influencing factors and their relationships of risk perception and decision-making behaviour of polypharmacy in patients with chronic diseases: a qualitative descriptive study
title_full Influencing factors and their relationships of risk perception and decision-making behaviour of polypharmacy in patients with chronic diseases: a qualitative descriptive study
title_fullStr Influencing factors and their relationships of risk perception and decision-making behaviour of polypharmacy in patients with chronic diseases: a qualitative descriptive study
title_full_unstemmed Influencing factors and their relationships of risk perception and decision-making behaviour of polypharmacy in patients with chronic diseases: a qualitative descriptive study
title_short Influencing factors and their relationships of risk perception and decision-making behaviour of polypharmacy in patients with chronic diseases: a qualitative descriptive study
title_sort influencing factors and their relationships of risk perception and decision making behaviour of polypharmacy in patients with chronic diseases a qualitative descriptive study
url https://bmjopen.bmj.com/content/11/4/e043557.full
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