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Liquori G, Panattoni N, De Leo A, Dionisi S, Giannetta N, Gasperi B, Orsi GB, Di Muzio F, Di Muzio M, Di Simone E. A Phenomenological Approach to Medication Adherence in Elderly Patients: A Qualitative Study. Healthcare (Basel) 2024; 12:1925. [PMID: 39408105 PMCID: PMC11476112 DOI: 10.3390/healthcare12191925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 09/12/2024] [Accepted: 09/23/2024] [Indexed: 10/20/2024] Open
Abstract
Background: Patient adherence to drug treatment is crucial to the success of any prescribed therapy, especially in chronic conditions. The present phenomenological qualitative study aims to explore the elderly experience in managing their medication therapy and their perception of medication adherence. Methods: Based on Husserl's perspective, a qualitative descriptive study was conducted utilizing the phenomenological approach, specifically Interpretative Phenomenological Analysis (IPA). The data analysis followed Giorgi's phenomenological approach and the inductive content analysis method. Approval for the study was obtained from the relevant Ethics Committee. Results: Themes emerged when participants described experiences about their own adherence to therapy. The following general theme emerged from the interviews and the phenomenological analysis: Generating awareness: taking therapy saves your life. It was followed by three other themes: (1) Drug therapy awareness; (2) Drug therapy in daily life; and (3) Drug therapy as a life partner. Conclusions: Elderly patients undergoing polypharmacological treatment emphasize the key factors for improving medication adherence, highlighting the influence of individual, motivational, and relational aspects. They express a strong desire for information and value the support of family doctors and nurses in managing therapy. Patient interviews indicate general support among elderly patients for using mobile health in pharmacological treatment, recognizing its potential and limitations.
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Affiliation(s)
- Gloria Liquori
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00128 Rome, Italy; (G.L.); (B.G.)
| | - Nicolò Panattoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (N.P.); (G.B.O.); (E.D.S.)
| | - Aurora De Leo
- Nursing Research Unit IFO, IRCCS Istituti Fisioterapici Ospitalieri, 00144 Rome, Italy;
| | - Sara Dionisi
- Nursing, Technical, Rehabilitation Department, DaTeR Azienda Unità Sanitaria Locale di Bologna, 40121 Bologna, Italy;
| | - Noemi Giannetta
- Departmental Faculty of Medicine, Saint Camillus International University of Health and Medical Sciences (UniCamillus), 00131 Rome, Italy;
| | - Beatrice Gasperi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00128 Rome, Italy; (G.L.); (B.G.)
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (N.P.); (G.B.O.); (E.D.S.)
| | | | - Marco Di Muzio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Di Simone
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (N.P.); (G.B.O.); (E.D.S.)
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Mucherino S, Rafaniello C, Serino M, Zinzi A, Trama U, Capuano A, Menditto E, Orlando V. Drug Utilization and Measurement of Medication Adherence: A Real World Study of Psoriasis in Italy. Pharmaceutics 2023; 15:2647. [PMID: 38139989 PMCID: PMC10747905 DOI: 10.3390/pharmaceutics15122647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/24/2023] Open
Abstract
Exceptional advances have been made with systemic treatment for psoriasis (PSO). However, that disease still represents a heavy burden in terms of impact on healthcare systems worldwide. This study comprehensively assesses medication adherence in a real world setting in Italy across all phases-initiation, implementation, and persistence-of PSO therapies. By distinguishing between switches and swaps, it provides unique insights into the patient's own approach to prescribed therapy as well as clinical decision-making processes, enhancing our understanding of medication adherence and discontinuation in a real world daily setting. The study's refined methodology for assessing persistence, considering variations in refill gaps and complex dosing regimens, shows that anti-interleukin (IL) therapies are associated with longer periods of adherence compared with other available therapeutic strategies. Among the selected drugs, ixekizumab and secukinumab were the ones with higher rate of treatment adherence at the expense of anti-TNF-α and anti-PDE4 agents. Notably, patients who opt for swaps are approximately 2.8 times more likely to discontinue their PSO therapy within one year. These findings carry practical implications for optimizing medication adherence, including tailored patient counseling, monitoring, and therapeutic adjustments, highlighting the need for a comprehensive and patient-centered approach to managing these conditions.
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Affiliation(s)
- Sara Mucherino
- Center of Pharmacoeconomics and Drug Utilization Research (CIRFF), Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (S.M.); (M.S.); (E.M.)
| | - Concetta Rafaniello
- Department of Experimental Medicine—Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Naples, Italy; (C.R.); (A.Z.); (A.C.)
| | - Marianna Serino
- Center of Pharmacoeconomics and Drug Utilization Research (CIRFF), Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (S.M.); (M.S.); (E.M.)
| | - Alessia Zinzi
- Department of Experimental Medicine—Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Naples, Italy; (C.R.); (A.Z.); (A.C.)
| | - Ugo Trama
- Regional Pharmaceutical Unit, Campania Region, 80143 Naples, Italy;
| | - Annalisa Capuano
- Department of Experimental Medicine—Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Naples, Italy; (C.R.); (A.Z.); (A.C.)
| | - Enrica Menditto
- Center of Pharmacoeconomics and Drug Utilization Research (CIRFF), Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (S.M.); (M.S.); (E.M.)
| | - Valentina Orlando
- Center of Pharmacoeconomics and Drug Utilization Research (CIRFF), Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (S.M.); (M.S.); (E.M.)
- HealthCare Datalab, Campania Region, 80143 Naples, Italy
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