Social context, the struggle with uncertainty, and subjective risk as meaning-rich constructs for explaining HBP noncompliance.

Abstract

OBJECTIVE: To identify the reasons for which people fail to take blood-pressure-lowering medication regularly, a qualitative study was conducted. METHODS: Interviews lasting approximately 90 min were conducted with 27 patients (15 women, 12 men) aged 40-70. The verbatim of the 27 interviews was first read and divided into segments with explanatory value. This was followed by the production of a final text in vignette form for all interviews. An integrative, analytical phase consisted of identifying trends, significant central themes, regularities, and divergences in the vignettes. RESULTS: Analysis revealed the explanatory power that 3 broad groups of subjective meanings could hold for given medication noncompliance scenarios. These scenarios are expressing the role of: (1) stress and living conditions in the occasional skipping or deferral of medication-taking; (2) doubt as the motivating factor for transitory, irregular medication use; (3) subjective risk as the motivating factor for persistent irregular use. CONCLUSION: Life and social contexts, doubt and risk subsume extremely meaning-rich constructs that can help identify dilemmas facing people about medication-taking. PRACTICE IMPLICATIONS: By discussing these dimensions with their patients, health professionals will be better able to understand patient medication behaviors that sometimes run counter to their recommendations.