Learning Objective 1: The learner will be able to understand the use of motivational interviewing in helping people to take medicines as prescribed for chronic conditions
Learning Objective 2: The learner will be able to recognise the socio-emotional implications of having to take multiple prescribed medicines every day
An exploration of people’s motivation and confidence to take their medicines as prescribed in the presence of co-existing chronic conditions (diabetes, chronic kidney disease and hypertension).
Motivational interviewing telephone calls were conducted with participants aged ≥ 18 years of age with diabetes, chronic kidney disease and hypertension who were recruited from outpatients’ clinics of an Australian metropolitan hospital. Around four motivational interviewing telephone calls were made with each participant (n=39) over 12 weeks in the intervention arm of a randomised controlled trial. The data was analysed according to an atheoretical framework of qualitative data analysis.
The 39 participants were aged 68 years (mean), were mostly male, were prescribed 7.6 (mean) medicines daily (excluding insulin and over the counter preparations), and reported 7.7 (mean) other chronic conditions. Four core themes emerged, which were discontent with the medical model of care, actively managing health, trying to manage health, and overwhelming complex health problems. Subthemes were identified from the four core themes. Participants wanted to take control of their health, and developed various coping strategies to manage their lives on a daily basis. The participants’ motivation and confidence in taking their medicines was set back by their complex medicine regimens and medical conditions. Participants were overwhelmed even though they valued the medicines that kept them alive. Unstable health readings and symptomless diseases, irrespective of their seriousness, provided minimal incentives to take medicines as prescribed.
Taking multiple prescribed medicines is a daily reminder of vulnerable health states with major psychological consequences affecting medicine adherence. People with long-term medical conditions require simplification of their medicine regimens and ongoing emotional and social support to help them to manage their health long-term.