Erratum to: The Contribution of Qualitative Research to Medication Adherence

Abstract

In this chapter, I discuss definitions and classifications of medication non-adherence, the scope and consequences of non-adherence, the history of medication adherence research, the Ten Tenets of Medication Adherence, and the implications of the Ten Tenets for teaching and education. Throughout the exposition of the Ten Tenets of Medication Adherence, I underscore the role of qualitative inquiry in furthering our understanding of medication non-adherence from the patient point of view. In this chapter, I provide evidence from the peer-reviewed literature on how qualitative research has illustrated how patients do not tell their provider if they do not want a prescription medication, how patients choose not to discuss their non-adherence decisions with their providers, and how physicians simply presume their patients are adherent and fail to proactively ask patients about medication adherence. Qualitative research has also elegantly portrayed patients’ dissatisfaction and frustration with the information they receive from their prescribers about newly prescribed medications. I also provide evidence from the peer-reviewed literature on how qualitative research has: (1) shed light on how medication taking is an active, rational, and reasoned decision-making process; (2) illustrated how patients carry out their own cost-benefit analysis by balancing their concerns about medications against their perceived need for the therapy and its perceived benefits; (3) depicted how patients assign differential worth and importance to their medications and make their own subjective trade-offs among medications; (4) shown how patients resist taking prescription medications; (5) described a variety of patient concerns, including that medications are seen as dangerous and addictive and that the treatment could be worse than the disease; and (6) revealed that many patients experiment with medications in order to test their efficacy or assess the tractability or permanency of side effects. As a result of the body of qualitative research on medication non-adherence, it is now understood that non-adherence is neither deviant nor irrational behavior on the part of patients. Non-adherence is a psychosocial marker for the fact that issues important to the patient were not addressed—that patients have unvoiced concerns and uncertainties about their disease and the prescribed therapy.