Experiences of patients receiving Home Care and living with polypharmacy: a qualitative interview study

Abstract

Background: In Sweden, patients receiving Home Care (HC) are older people with frailty and multimorbidity, and are often treated with many medicines. Their perspectives on polypharmacy have been sparsely explored. Aim: To investigate HC patients’ experiences and perceptions regarding polypharmacy. Design & setting: Semi-structured interviews with 17 patients with HC in Stockholm, Sweden. Method: The interview questions were open and aimed to encourage participants to speak freely about their personal experiences of living with polypharmacy. Data were analysed using an inductive thematic analysis. Results: The participants’ median age was 83.5 years (range 74–97 years) and the median number of prescribed medicines was 11 (range 5–30). The following two themes were identified: (1) experiences from daily life with polypharmacy; and (2) dependency on the relationship to healthcare professionals. The first theme contains the main finding, which was the diversity in how older people experienced polypharmacy and how they coped with polypharmacy in everyday life. While some were satisfied despite having multiple medicines, others experienced such psychological unease owing to polypharmacy that it led to reduced quality of life. The second theme reflects the importance of the relationship between the older person and healthcare professionals for medicine-related ideas and attitudes. Conclusion: The individual variation in experiences regarding polypharmacy points to the value of interprofessional teamwork with the patient as an active partner. Therefore, healthcare professionals need to adapt a more person-centred approach where the patient’s perspectives are respected and considered in medicine-related decisionmaking.

Keywords

• general practice
• health services for the aged
• polypharmacy
• multimorbidity
• frailty
• psychosocial functioning
• primary healthcare