Determinanten van therapietrouw met inhalatiemedicatie bij COPD patiënten

Dessenes, M. (2015) Determinanten van therapietrouw met inhalatiemedicatie bij COPD patiënten.

Abstract:Background: For years now the lung department of Medisch Spectrum Twente has done research with COPD patients. For example, a COPD cohort was launched in 2005 with 795 COPD patients, which primarily investigated mortality and inflammation. Adherence too was an important research area in the cohort. Adherence rates were determined using pharmacy data with a follow up of three years and was divided into optimal, suboptimal, over- and underuse. Adherence is a major theme in self-management of chronic physical illness like COPD. In this current study the determinants and underlying motives associated with over- and under-use of inhaled medications are investigated. Methods: Design: The design of this study consisted of conducting semi-structured in-depth interviews with COPD patients. Next, on the basis of a thematic analysis of the obtained data research questions were answered. Respondents: The respondents who participated in this study originating from the cohort of the COMIC study (Koehorst-ter Huurne, Movig, Van der Valk, Van der Palen, Brusse-Keizer, 2015). For the interviews 20 respondents were used, consisting out of an equal number of under- and over users. Procedure: patients from the COMIC study were contacted by phone. Thereafter they were sent an Information letter for participants. If the patient agreed to the request to participate in the study, the patient was asked to send a consent form back. During the actual interview, the patient was again informed about the study, the patient was given opportunity to ask questions and voluntariness was stressed. Afterwards, the respondent was once again given the opportunity to ask questions. Measuring Instrument: During the interview respondents were asked questions. The questions focused on the person dependent factors, treatment factors and pharmacological factors that may affect treatment adherence of patients with COPD. Results: The results have shown that the described illness and treatment beliefs play a role in context of the disease. Moreover, these beliefs are related to non adherence. Finally, it has been found that the illness and treatment beliefs can hardly distinguish between under- and over-users of inhaled medication. Between the under- and over users, the following differences have occurred: under users have more (negative) beliefs about the timeline of the disease, over users experience more severe consequences, under users believed more often than over users that medication could not reduce complaints, under users are more convinced that the medication cannot prevent exacerbations and over users more often described being dependent of the medication. Conclusion: Research has shown that illness and treatment beliefs play a role in the experience of the respondents. The described beliefs are related to non adherence. By contrast the beliefs virtually made no distinction between under- and over users of inhaled medication. Themes medication necessity revealed some significant differences between under- and of over users.
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology BSc (56604)
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