Storied Experiences of Managing Polypharmacy in Primary Care

Monday, 9 November 2015

Johnanna Hernandez, PhD, MSN, RN, APRN, FNP-BC
Nursing, Baylor University, Providence Village, TX, USA

Polypharmacy is a global epidemic. The World Health Organization (WHO) identifies polypharmacy, the irrational use of medications as a major global problem resulting in wasting of scarce resources and widespread health hazards. A qualitative study used narrative inquiry to explore understanding and meanings of the nurse practitioner’s (NPs) professional experience in managing polypharmacy in primary care. In this study, seeking to understand meaning of NPs with a particular issue, temporality was a central feature. Using the three-dimensional narrative inquiry space during data analysis allowed the researcher to view the temporal aspect of the stored experiences as something that has happened over time and to organize the NPs experiences into temporally meaningful episodes. The personal/social interaction was also important as the co-dependency between the two contextualized all aspects of the NP’s experience in their practice environments, or place. NP narratives revealed motives, experiences, and actions, and the way they interpret and assign meaning to them in relation to their NP role in managing polypharmacy. Thematic analysis of narratives revealed the complexities of managing polypharmacy and highlighted issues which must be addressed given one in five people will be over age 60 years by 2050, accounting for approximately half of the total growth of the world population.