Journal
DISABILITY AND REHABILITATION
Volume 44, Issue 1, Pages 24-33Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2020.1756000
Keywords
Spinal cord injuries; polypharmacy; self-management; medication-taking; qualitative; Canada
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Funding
- Craig H. Neilsen Foundation [Psychosocial Research Pilot Grant] [441259]
- Connaught New Investigator Award (University of Toronto)
- Graduate Department of Pharmaceutical Sciences at the University of Toronto (Dean's Fund)
- Graduate Department of Pharmaceutical Sciences at the University of Toronto (Clinical, Social & Administrative Pharmacy Professors' Award for Thesis Research)
- Graduate Department of Pharmaceutical Sciences at the University of Toronto (Pfizer Canada Fellowship in Health Outcomes Research)
- Health System Performance Network
- Ontario Ministry of Health and Long Term Care Health Services Research Fund [06034]
- Canadian Institutes of Health Research Embedded Clinician Scientist Salary Award on Transitions in Care (2016-2020)
- Ontario Health (Quality)
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This study aimed to explore the attitudes, beliefs, and experiences of community-dwelling adults with spinal cord injury/dysfunction (SCI/D) in Ontario, Canada, regarding the management of prescribed and unprescribed medications. The findings revealed that medication management is a complex process that does not align with current medication management frameworks. Therefore, it is important to consider the self-management experiences of individuals with SCI/D in future research, practice, and policy.
Purpose: To explore the attitudes, beliefs and experiences pertaining to the management of prescribed and unprescribed medications among community-dwelling adults with spinal cord injury/dysfunction (SCI/D) in Ontario, Canada. Materials and Methods: In-depth semi-structured interviews were conducted by telephone. Each interview was audio-recorded, transcribed verbatim and analyzed using inductive thematic analysis. Results: Of the 19 participants, 11 were male and 8 were female, with an age range from 36 to 76 years; 14 participants had traumatic SCI and 5 had non-traumatic spinal cord dysfunction. All but three participants were taking five or more medications, including prescription medications, over-the-counter medications and natural health products. The three main themes identified were: disruptive nature of medications, fear of negative outcomes and self-management: playing a critical role. Conclusions: Medication management is a complex, multifaceted and non-linear process. Persons with SCI/D described experiences with medication-taking that are not well understood by current medication management frameworks. Thus, it is essential to broaden our lens and situate persons with SCI/D medication-taking experiences within self-management frameworks to allow for a more comprehensive and reflective understanding of their experiences. Based on the findings from this study, recommendations for future research, practice and policy have been suggested.
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