Home Care Patients’ Experiences with Home Care Nurses’ Support in Medication Adherence

Abstract

Nienke E Dijkstra,1,2 Marcia Vervloet,3 Carolien G M Sino,1 Eibert R Heerdink,2,4 Marjorie Nelissen-Vrancken,5 Nienke Bleijenberg,1,6 Marijn de Bruin,7 Lisette Schoonhoven6,8 1Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, the Netherlands; 2Research Group Innovation in Pharmaceutical Care, University of Applied Sciences Utrecht, Utrecht, the Netherlands; 3Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 4Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; 5Dutch Institute for Rational Use of Medicine, Utrecht, the Netherlands; 6Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; 7IQ Healthcare, Radboud University Medical Centre, Nijmegen, the Netherlands; 8School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southhampton, UKCorrespondence: Nienke E DijkstraResearch Group Proactive Care for Elderly People Living at Home, University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS, the NetherlandsTel [phone]Email [email protected]: To describe nurses’ support interventions for medication adherence, and patients’ experiences and desired improvements with this care.Patients and Methods: A two-phase study was performed, including an analysis of questionnaire data and conducted interviews with members of the care panel of the Netherlands Patients Federation. The questionnaire assessed 14 types of interventions, satisfaction (score 0– 10) with received interventions, needs, experiences, and desired improvements in nurses’ support. Interviews further explored experiences and improvements. Data were analyzed using descriptive statistics and a thematic analysis approach.Results: Fifty-nine participants completed the questionnaire, and 14 of the 59 participants were interviewed. The satisfaction score for interventions was 7.9 (IQR 7– 9). The most common interventions were: “noticing when I don’t take medication as prescribed” (n = 35), “helping me to find solutions to overcome problems with using medications” (n = 32), “helping me with taking medication” (n = 32), and “explaining the importance of taking medication at the right moment” (n = 32). Fifteen participants missed ≥ 1 of the 14 interventions. Most mentioned the following: “regularly asking about potential problems with medication use” (33%), “regularly discussing whether using medication is going well” (29%), and “explaining the importance of taking medication at the right moment” (27%). Twenty-two participants experienced the following as positive: improved self-management of adequate medication taking, a professional patient–nurse relationship to discuss adherence problems, and nurses’ proactive attitude to arrange practical support for medication use. Thirteen patients experienced the following as negative: insufficient timing of home visits, rushed appearance of nurses, and insufficient expertise about side effects and taking medication. Suggested improvements included performing home visits on time, more time for providing support in medication use, and more expertise about side effects and administering medication.Conclusion: Overall, participants were satisfied, and few participants wanted more interventions. Nurses’ support improved participants’ self-management of medication taking and enabled patients to discuss their adherence problems. Adequately timed home visits, more time for support, and accurate medication-related knowledge are desired.Keywords: medication adherence, patient preference, home care, home care nurses, patient satisfaction, patient adherence

Keywords

• medication adherence
• patient preference
• home care
• home care nurses
• patient satisfaction
• patient adherence