A Qualitative Exploration of Perceived Medication Adherence Determinants Conducted Among Older Adults with HIV and Type 2 Diabetes Mellitus
Year: 2023
Type: article
Abstract: Background: People living with HIV (PLWH) are at higher risk of developing type 2 diabetes (T2DM). Both chronic conditions require individuals to adhere to medication regimens, yet few studies have sought to explore medication-taking behaviors among individuals with comorbid HIV and T2DM (HIV+T2DM). Objective: This qualitative study sought to: 1) identify and compare perceived determinants of medication adherence for HIV and, separately, for T2DM, and 2) explore how participants prioritize conditions. Methods: Between October 2022 and January 2023, we conducted in-depth interviews with individuals aged 50 or older, living with comorbid HIV+T2DM. Participants were prescribed oral medications to treat their conditions and had recent clinical measures indicating probable challenges with medication adherence. Interviews with consented participants from a large academic health center in the Midwest were conducted remotely. Questions largely drew from the Theoretical Domains Framework (TDF), a widely used implementation science framework. Additional questions explored the prioritization of conditions. Analysis employed the Framework Method and a side-by-side comparison of key determinants of medication adherence by condition. Results: A total of 19 interviews were audio recorded, transcribed, and analyzed. Participants were an average age of 61, mostly male (89.5%), and Non-Hispanic White (47.4%). Although results revealed many commonalities between perceived determinants of medication adherence for HIV and for T2DM, differences relating to two TDF domains were noted: nature of the behavior (taking medications as prescribed), and motivations and goals. Many participants viewed their conditions as equally important, though they suggested T2DM was more difficult to manage, largely due to lifestyle modifications. Conclusion: As individuals with HIV develop chronic conditions, such as T2DM, they may require additional medication adherence support. Attention should be paid to offering support early. Disease perceptions may differ by condition, and as such, one's motivations to take medication as prescribed may also differ by condition.
Source: Patient Preference and Adherence
DOI: 10.2147/ppa.s431869
Authors: Allison Pack, Mary Clare Masters, Rachel O'Conor, Kenya Alcantara, Sophia Svoboda, Reneaki Smith, Fangyu Yeh, Guisselle Wismer, Amisha Wallia, Stacy Bailey
Institution: Northwestern University
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
Funders: Gordon and Betty Moore Foundation, Eli Lilly and Company, Pfizer, Sanofi, Gilead Sciences, Northwestern University, University of Chicago, UnitedHealth Group, University of Westminster, H. Lundbeck A/S, National Institutes of Health, Directorate for Biological Sciences, Feinberg School of Medicine, Chicago Center for Diabetes Translation Research, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences
Awards: G1679481751, G3515949408, G4517371900, Northwestern University Clinical and Translational Science Institute (NUCATS), Third Coast HIV-Related Cardiovascular and Sleep Disorders K12 Career Development Program, G5145007563, G5884829157, The Claude D. Pepper Older Americans Independence Center (OAIC) at Northwestern University, G9000196732, Chicago Center for Diabetes Translation Research, HIV Clinic-based Screening for Geriatric Syndromes in Older Adults with HIV
OpenAlex ID: W4388024637