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Keele’s ‘Important News and Evidence’ Service
KINES
Rapid Update
May 2016
Medication-related burden and patients’ experience with medicine: A review of
qualitative studies
A systematic review and meta-synthesis of qualitative studies found that people with chronic conditions and an
intolerable medication-related burden may discontinue treatment and have poor health outcomes. Prescribers should
consider the impact of a person’s medication on their day-to-day life and provide individualised care to minimise the
burden of treatment. The NICE guideline on medicines optimisation makes recommendations on medication review,
with a view to minimising medication-related problems.
Medication-related burden and patients’ lived experience with medicine: a systematic review and metasynthesis of
qualitative studies. Mohammed MA, Moles RJ, Chen TF BMJ Open. 2016; 6:e010035 doi:10.1136/bmjopen-2015010035
What do we know already?
The last decade has seen an increase in clinical trials that consider patients’ experience with medicines, with a
number of studies focussing on patient-reported outcomes in relation to a specific condition or treatment. A
retrospective cohort study by Schmittdiel et al. (2014) considered the medication-related burden of people with
newly-diagnosed type 1 or type 2 diabetes, concluding that these people have a significant drug burden although
this may slightly decrease over time. In their retrospective chart review study Weinstock et al. (2014) found that
people with bipolar disorder had a high medication burden, especially people who are currently experiencing
symptoms.
A systematic review by Boyce et al. (2014) concluded that healthcare professionals value patient-reported outcome
measures when they support the clinical decision-making process. The authors suggested that improvements to
the interpretability of patient-reported outcome measures should increase their use.
The NICE guideline on medicines optimisation recommends that a structured medication review should take into
account a person’s views and understanding about their medicines, including any concerns, questions or problems
they my have.
What does this evidence add?
This systematic review and meta-synthesis of qualitative studies provides new information on medication-related
burden and how patients’ experiences can affect outcomes for people with chronic conditions. The authors
concluded that medication-related burden can have a negative effect on patients’ day-to-day lives, ultimately
leading to poorer health outcomes.
The authors suggest that healthcare professionals should attempt to gain insight into patient experiences with their
medication to help them identify potential medication-related burden. This approach could lead to better
individualised care through treatments that suit a patient’s life.
Study details
Participants:
Systematic review and meta-synthesis of 34 qualitative studies that explored 3 themes related to patients’ lived
experience with medicines: medication-related burden, medication-related beliefs and medication-taking practice.
The studies were conducted in 12 different countries, with 11 studies from the UK, and included a total of
1,144 participants. The studies were conducted across various primary and secondary care settings.
KINES is produced by The Centre for Medicines Optimisation at Keele University for subscriber CCGs. The views expressed are Keele’s and may not reflect local prescribing guidance.
External hyperlinks are provided as a convenience but are out of Keele’s control and do not constitute an endorsement by Keele.
Intervention and comparison:
 Information on patient experiences with medicines was gathered using focus groups, and semi-structured
telephone or face-to-face interviews.
Outcomes and results:
The review found medication-related burden can influence a person’s health and well-being, beliefs and behaviour.
Some people can adapt to the burden imposed by their medication, while others are unable to. Medication-related
burden can have a negative impact on well-being, leading to potential drug-related problems.
People experiencing medication-related burden may begin to modify their medicines themselves, or continue
treatment at the expense of their physical, social or psychological well-being. Intolerable medication burden may
lead to non-adherence and poor outcomes, resulting in unachieved therapeutic goals and damage to health.
The authors concluded a good understanding of patients’ lived experience with medicines is required when making
therapeutic decisions, and engaging with these experiences may help improve individualised care.
Level of evidence:
Level 1 (good quality patient-oriented evidence) according to the SORT criteria.
Study funding: No specific funding from the public, commercial or not-for-profit sectors.