Descriptive study of homeless patients' perceptions that affect medication adherence.

Purpose Results of a study to elucidate perceptions, attitudes, and beliefs about prescribed medications held by hospitalized patients who are homeless are reported. Methods A qualitative descriptive study involving semistructured interviews was conducted to gather information and characterize hospi...

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Published in:American Journal of Health-System Pharmacy Vol. 76; no. 17; pp. 1288 - 1296
Main Authors: Richler, Matthew J, Yousaf, Sara, Hwang, Stephen W, Dewhurst, Norman F
Format: research tables/charts Journal Article
Published: Oxford University Press / USA 9/1/2019
Online Access:View this record in EBSCOhost
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      dt: 9/1/2019
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      pub: Oxford University Press / USA
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        atl: Descriptive study of homeless patients' perceptions that affect medication adherence.
      aug:
        au:
          Richler, Matthew J
          Yousaf, Sara
          Hwang, Stephen W
          Dewhurst, Norman F
        affil: St. Michael's Hospital, Toronto, Canada, and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
      sug:
        subj:
          Homeless Persons Psychosocial Factors
          Patient Attitudes
          Medication Compliance
          Health Beliefs
          Prescribing Patterns
          Human
          Descriptive Research
          Inpatients Psychosocial Factors
          Qualitative Studies
          Semi-Structured Interview
          Emergency Service
          Office Visits
          Length of Stay
          Health Care Costs
          Internal Medicine
          Patient Admission
          Tertiary Health Care
          Audiorecording
          Middle Age
          Mental Disorders Therapy
          Middle Aged: 45-64 years
      ab: Purpose Results of a study to elucidate perceptions, attitudes, and beliefs about prescribed medications held by hospitalized patients who are homeless are reported. Methods A qualitative descriptive study involving semistructured interviews was conducted to gather information and characterize hospitalized homeless patients' views and attitudes regarding medication use, with a focus on medication nonadherence. Medication nonadherence has been shown to be a factor contributing to higher rates of emergency department visits, increased hospital lengths of stay, and increased healthcare costs in homeless populations. Interviews were conducted during patients' admissions to the internal medicine service of a tertiary care, inner-city hospital. Interviews were audio-recorded and transcribed. Data were analyzed using conventional qualitative content analysis to generate data-driven codes and themes. Results Twelve interviews were conducted (median patient age, 48.5 years). Eight patients (66.7%) were living in a shelter, and 11 (91.7%) had a mental illness. Patients were prescribed a median of 4 medications at the time of hospital admission. Four themes were identified: (1) a new appreciation of medications was acquired during hospitalization, (2) medications were perceived as necessary for maintaining health, (3) there was an interest in receiving medication education, and (4) concerns were expressed regarding medication adverse effects. Conclusion In interviews conducted during hospital admission, homeless patients expressed positive perceptions about the necessity of their medications but also concerns about medication adverse effects. Interventions to improve adherence may be successful if directed toward addressing treatment-related concerns.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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