Facilitators and barriers to medication self-management for patients with multiple long-term conditions transitioning from hospital to home

Abstract

Background

Being a patient with multiple long-term conditions (MLTCs) often entails a need for complex medication treatment, which poses a challenge to medication self-management. Medication self-management during transition of care is often hindered by challenges such as inadequate communication, which increases the risk of medication errors and adverse outcomes.

Aim

Identify facilitators and barriers to medication self-management for patients with MLTCs transitioning from hospital to home.

Methods

Semi-structured interviews were conducted in patient's homes 1–2 weeks after hospital discharge. Interviews were transcribed and analysed by qualitative deductive content analysis using the Taxonomy of Every Day Self-management Strategies (TEDSS) framework. The data collection continued until enough information power and meaning saturation was reached.

Results

Twenty-one patients and three next of kin participated. Numerous facilitators and barriers to medication self-management were identified within all seven TEDSS domains, which varied extensively between individuals. Resource and process strategies were the most frequently discussed domains, while health behaviour and social interaction strategies were less frequently discussed. Key facilitators identified were access to resources that support medication self-management and knowing the medication's purpose. Key barriers included patients perceiving medications as burdensome or not recognising the importance of their medications.

Conclusions

This study highlights the complex and wide spectre of facilitators and barriers to medication self-management for patients with MLTCs transitioning from hospital to home. In clinical practice, patients' medication self-management could be supported through a holistic approach adapted to the individual patient's daily life, including improved care coordination and patient empowerment.