Medication Management & Chronic Illness
By Kim Deng
Imagine living as an older adult with a chronic illness, leaving the doctor’s office with multiple prescriptions in hand. How would you remember to take all those pills? Researchers in Germany interviewed 27 people, with an average age of 62 (21 of them with a chronic heart condition and six living with HIV/AIDS) for their medication management insights.
The researchers divided their qualitative findings into four different phases: onset, restabilization, ongoing illness, and increasing complexity.
1. Onset of medication taking
- Upon onset diagnosis, the habit of taking medications on a regular basis has not been formed.
- The initial shock of being diagnosed with a life-long illness usually leaves some patients feeling helpless, agreeing to take the prescriptions.
- Because it’s an onset diagnosis, others patients fail to see the gravity of their illness and don’t start taking medication right away or at all.
2. Restabilization
- People in this stage have passed their initial shock and are trying to work toward a “normal life” by trying to improve their health.
- They’re in full compliance with taking medication during this phase, but they have no guidance from medical professionals on how to manage routine medication intake.
3. Ongoing illness
- They’ve accepted the fact they have to take a lifetime of medication at this point. Any hope of becoming “normal” and healthy has been replaced with the acceptance of their illness.
- They tend to self-manage their medication schedule; e.g., try to form a habit in taking pills such as brushing teeth.
4. Increasing complexity
- It’s difficult for chronically ill patients to keep track of all the different medications they’re taking, especially when co-morbidities and side effects come into play. New drugs may be added and they may try to ask their physicians to reduce the amount that they have to take.
- Others self-manage by either asking their physicians to reduce the amount of drugs they have to take or adjusting their own schedule to fall into a routine with their prescription medications.
Many people surveyed expressed that they don’t have adequate information regarding their medication or how to develop a routine in taking them. Most often, doctors leave the patients to figure that out on their own or assume that they will rely on family. Perhaps the relationship between doctor and patient can extend to offering methods on how to develop a routine.
Source: Haslbeck, J. 2009. Routines in Medication Management: The Perspective of People with Chronic Conditions. Chronic Illness (Forthcoming).
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