Experiences of patients receiving Home Care and living with polypharmacy: a qualitative interview study

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Abstract

Background

In Sweden, patients receiving Home Care (HC) are older people with frailty and multimorbidity, and are often treated with many medicines. Their perspectives on polypharmacy have been sparsely explored.

Aim

To investigate HC patients’ experiences and perceptions regarding polypharmacy.

Design & setting

Semi-structured interviews with 17 patients with HC in Stockholm, Sweden.

Method

The interview questions were open and aimed to encourage participants to speak freely about their personal experiences of living with polypharmacy. Data were analysed using an inductive thematic analysis.

Results

The participants’ median age was 83.5 years (range 74–97 years) and the median number of prescribed medicines was 11 (range 5–30). The following two themes were identified: (1) experiences from daily life with polypharmacy; and (2) dependency on the relationship to healthcare professionals. The first theme contains the main finding, which was the diversity in how older people experienced polypharmacy and how they coped with polypharmacy in everyday life. While some were satisfied despite having multiple medicines, others experienced such psychological unease owing to polypharmacy that it led to reduced quality of life. The second theme reflects the importance of the relationship between the older person and healthcare professionals for medicine-related ideas and attitudes.

Conclusion

The individual variation in experiences regarding polypharmacy points to the value of interprofessional teamwork with the patient as an active partner. Therefore, healthcare professionals need to adapt a more person-centred approach where the patient’s perspectives are respected and considered in medicine-related decisionmaking.

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Most cited references 36

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Using thematic analysis in psychology

Virginia Braun, Victoria Clarke (2014)

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Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

A Tong, P SAINSBURY, J. Craig (2007)

Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.

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Is Open Access

Saturation in qualitative research: exploring its conceptualization and operationalization

Benjamin Saunders, Julius Sim, Tom Kingstone … (2017)

Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.

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Author and article information

Journal

Journal ID (nlm-ta): BJGP Open

Journal ID (iso-abbrev): BJGP Open

Journal ID (publisher-id): bjgpoa

Journal ID (hwp): bjgpoa

Title: BJGP Open

Publisher: Royal College of General Practitioners

ISSN (Electronic): 2398-3795

Publication date Collection: June 2022

Publication date (Electronic, pub): 20 April 2022

Publication date PMC-release: 20 April 2022

Volume: 6

Issue: 2

Electronic Location Identifier: BJGPO.2021.0181

Affiliations

[1 ] deptStockholm Region and Division of Family Medicine and Primary Care , Academic Primary Healthcare Centre , Stockholm, Sweden

[2 ] deptDivision of Nursing , Department of Neurobiology, Care Sciences and Society, Karolinska Institute , Stockholm, Sweden

[3 ] Karolinska Institute, Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska University Hospital , Stockholm, Sweden

[4 ] deptPedagogue , Region Stockholm, Health Care Administration , Stockholm, Sweden

[5 ] Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Karolinska University Hospital Huddinge , Sweden

Author notes

*For correspondence: Stina Mannheimer, stina.mannheimer@ 123456gmail.com

Author information

Katharina Schmidt-Mende http://orcid.org/0000-0003-0446-8930

Article

Publisher ID: 0181

DOI: 10.3399/BJGPO.2021.0181

PMC ID: 9447318

PubMed ID: 35135816

SO-VID: 408e4161-6190-4781-b526-f81904f5535f

License:

This article is Open Access: CC BY license ( https://creativecommons.org/licenses/by/4.0/)

History

Date received : 30 September 2021

Date accepted : 30 November 2021

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Keywords: general practice,health services for the aged,polypharmacy,multimorbidity,frailty,psychosocial functioning,primary healthcare

Data availability:

Keywords: general practice, health services for the aged, polypharmacy, multimorbidity, frailty, psychosocial functioning, primary healthcare

Experiences of patients receiving Home Care and living with polypharmacy: a qualitative interview study

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Abstract

Background

Aim

Design & setting

Method

Results

Conclusion

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Chinese Journal of General Practice

Most cited references 36

Using thematic analysis in psychology

Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

Saturation in qualitative research: exploring its conceptualization and operationalization

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Affiliations

Author notes

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