4.4 Article

Spinal cord injury/dysfunction and medication management: a qualitative study exploring the experiences of community-dwelling adults in Ontario, Canada

Journal

DISABILITY AND REHABILITATION
Volume 44, Issue 1, Pages 24-33

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2020.1756000

Keywords

Spinal cord injuries; polypharmacy; self-management; medication-taking; qualitative; Canada

Categories

Funding

  1. Craig H. Neilsen Foundation [Psychosocial Research Pilot Grant] [441259]
  2. Connaught New Investigator Award (University of Toronto)
  3. Graduate Department of Pharmaceutical Sciences at the University of Toronto (Dean's Fund)
  4. Graduate Department of Pharmaceutical Sciences at the University of Toronto (Clinical, Social & Administrative Pharmacy Professors' Award for Thesis Research)
  5. Graduate Department of Pharmaceutical Sciences at the University of Toronto (Pfizer Canada Fellowship in Health Outcomes Research)
  6. Health System Performance Network
  7. Ontario Ministry of Health and Long Term Care Health Services Research Fund [06034]
  8. Canadian Institutes of Health Research Embedded Clinician Scientist Salary Award on Transitions in Care (2016-2020)
  9. 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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