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Barriers and facilitators to medication adherence: a qualitative study with general practitioners
  1. Kirsi Kvarnström1,
  2. Marja Airaksinen1,
  3. Helena Liira2,3
  1. 1 Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Finland
  2. 2 General Practice, School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
  3. 3 Department of General Practice and Primary Health Care, Helsinki University Central Hospital, University of Helsinki, Finland
  1. Correspondence to Kirsi Kvarnström; kirsi.kvarnstrom{at}helsinki.fi

Abstract

Background General practitioners (GPs) manage the drug therapies of people with chronic diseases, and poor adherence to medication remains a major challenge.

Objective This qualitative study examined GPs’ insights into non-adherence and ways of overcoming this problem.

Methods We ran four focus groups comprising 16 GPs at the Kirkkonummi Health Centre (Southern Finland). Interviews were audiotaped, transcribed verbatim and analysed by inductive content analysis.

Main results The two main themes in the discussions with the GPs were non-adherence in the care of chronic disease and increased need for medicine information. The medication management challenges identified were related to: patient-specific factors, the healthcare system, characteristics of drug therapies and the function and role of healthcare professionals as a team. To improve the situation, the GPs offered a number of solutions: improved coordination of care, better patient education and IT systems as well as enhanced interprofessional involvement in the follow-up of patients.

Discussion and conclusions With an ageing population, the GPs were increasingly confronted with non-adherence in the care of chronic diseases. They had mostly a positive attitude towards organising care in a more interprofessional manner. To support medication adherence and self-management, the GPs appreciated pharmacists’ assistance especially with patients with polypharmacy and chronic diseases.

  • general practitioner
  • medication adherence
  • inter-professional
  • pharmacist
  • qualitative research

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors Two convenors ran the focus groups: a moderator (KK) and a facilitator (either HL or another local general practitioner, Kaija Hannula). KK did the initial coding and analysis. All authors read the transcripts and results and the conclusions were chosen by discussion and consultation. All authors participated in the critical revision of the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The board of the Kirkkonummi Health Centre, which was the local ethics committee, granted the study permission. Based on Finnish ethical principles of research there was no need to apply for permission from the hospital district’s ethics committee for this voluntary focus group interview study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All requests should be directed to the corresponding author.

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