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Nakata C, Sharp LK, Spanjol J, Cui AS, Izberk-Bilgin E, Crawford SY, Xiao Y. Narrative arcs and shaping influences in long-term medication adherence. Soc Sci Med 2021; 285:114264. [PMID: 34329922 DOI: 10.1016/j.socscimed.2021.114264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/11/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
Long-term adherence to medications is not well understood and poses a significant challenge for many chronically ill persons. Past research provides insights on adherence in short durations such as a day or several weeks, even though chronically ill patients are required to take medications for periods as long as a lifetime. To fill this important knowledge gap, we study the temporal unfolding of prolonged medication-taking experiences among thirty adults, mostly African American, with chronic hypertension in the U.S. Specifically, we take an extended, experience-centered, narrative approach to examine retrospective patient accounts of adherence efforts over spans of one year to more than four decades. Applying Gergen and Gergen's concept of narrative forms (1983), we find four distinct narrative arcs, or patterned sequences of medication consumption, that we term Out of the Gate, Existential Turn, Fits and Starts, and Slow Climb, along with individual and social elements that shape and shift practices in the context of time.
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Affiliation(s)
- Cheryl Nakata
- Department of Marketing, Entrepreneurship, Hospitality, & Tourism, Bryan School of Business and Economics, University of North Carolina at Greensboro, 516 Stirling Street, 348 Bryan Building, Greensboro, NC, 27402, USA.
| | - Lisa K Sharp
- Institute for Health Research and Policy, 463 Westside Research Office Building, 1747 West Roosevelt Road, Chicago, IL, 60608, USA; Department of Pharmacy Systems, Outcomes, and Policy in the College of Pharmacy, University of Illinois at Chicago, 833 S. Wood Street (MC 871), Chicago, IL, 60612, USA.
| | - Jelena Spanjol
- Ludwig-Maximilians-Universität (LMU) München, LMU Munich School of Management, Geschwister-Scholl-Platz 1, 80539 München, Germany.
| | - Anna Shaojie Cui
- Department of Marketing, College of Business Administration, University of Illinois at Chicago, 601 S. Morgan (MC 243), Chicago, IL, 60607, USA.
| | - Elif Izberk-Bilgin
- Department of Management Studies, College of Business, University of Michigan-Dearborn, 151 FCS, Dearborn, MI, 48126, USA.
| | - Stephanie Y Crawford
- Department of Pharmacy Systems, Outcomes, and Policy in the College of Pharmacy, University of Illinois at Chicago, 833 S. Wood Street (MC 871), Chicago, IL, 60612, USA.
| | - Yazhen Xiao
- Department of Marketing, University of Tennessee, 321 Stokely Management Center, 916 Volunteer Boulevard, Knoxville, TN, 37996-0530, USA.
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