Cited by 18Spinal Cord Injury ResearchPharmacy and Medical PracticesPharmaceutical Practices and Patient Outcomes

Exploring the perspectives on medication self-management among persons with spinal cord injury/dysfunction and providers

Cadel, Lauren, Everall, Amanda C., Packer, Tanya L., Hitzig, Sander L., Patel, Tejal, Lofters, Aisha K., Guilcher, Sara J.T.·2020·Research in Social and Administrative Pharmacy

Abstract

Rationale Spinal cord injury/dysfunction (SCI/D) is an exemplar condition with a high prevalence of secondary complications, chronic conditions and use of multiple medications (polypharmacy). Optimizing medication self-management is important for persons with SCI/D to improve outcomes; however, there is a lack of research on how healthcare/service providers and persons with SCI/D experience medication self-management.Objective To explore attitudes and experiences of medication self-management from the perspectives of persons with SCI/D and providers, and to explore the extent to which the Taxonomy of Everyday Self-management Strategies (TEDSS) framework captured participants' experiences with medication self-management.Methods In-depth, semi-structured interviews were conducted by telephone until data saturation was reached. Interviews were transcribed verbatim and analyzed using constant comparative approaches. The TEDSS framework was adapted and applied deductively.Results Fifty-one individuals participated in this study, 32 providers and 19 persons with SCI/D. Disease controlling strategies was the domain discussed in most detail by all participants. In this domain, participants discussed managing medications and treatments, monitoring/managing side effects, and controlling complications. Process strategies (problem-solving, decision-making) and resource strategies (seeking support) were the next most frequently discussed domains. Among all participant groups, there was a lack of detailed discussion of social interactions, health behaviour, and internal strategies. Medication self-management support was not extensively discussed by any group.Conclusion This study highlighted the complex nature of medication self-management. While persons with SCI/D and providers discussed similar components of the TEDSS framework, providers had minimal reflections on the impact of medication self-management on everyday life. This study identified the need for explicit discussions between providers and persons with SCI/D, involving all components of self-management and self-management support in order to improve medication self-management.

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Crossref · 10.1016/j.sapharm.2020.01.014

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Authors
Cadel, L., Everall, A. C., Packer, T. L., Hitzig, S. L., Patel, T., Lofters, A. K., & Guilcher, S. J. T.
Affiliations
  • University of Toronto (CA)
  • Dalhousie University (CA)
  • Sunnybrook Health Science Centre (CA)
  • University of Waterloo (CA)
Corresponding author
Guilcher, Sara J.T.
Venue
Research in Social and Administrative Pharmacy
Publisher
Elsevier BV
Published
2020-12
Volume
16
Issue
12
Pages
1775-1784
ISSN
1551-7411 (ISSN-L)
OpenAlex
W3004182665
Cited by
18
References
54
Citations by year
2026: 3 · 2025: 6 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 2
FWCI
1.15
Type
journal article
Language
en
Open access
closed
Locations
  • Research in Social and Administrative Pharmacy (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • University of Toronto
  • Pfizer
  • Craig H. Neilsen Foundation (441259)
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
medication self-management, spinal cord injury, spinal cord dysfunction, polypharmacy, self-management support, patient and provider perspectives, secondary complications, patient experience
MeSH terms
Self-Management, Chronic Disease, Humans, Spinal Cord Injuries, Health Behavior, Polypharmacy

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