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Barriers to medication adherence in a rural-urban dual economy: a multi-stakeholder qualitative study.

Publication ,  Journal Article
Xu, J; Zhao, M; Vrosgou, A; Yu, NCW; Liu, C; Zhang, H; Ding, C; Roth, NW; Pan, Y; Liu, L; Wang, Y; Wang, Y; Bettger, JP
Published in: BMC Health Serv Res
August 12, 2021

BACKGROUND: One of the most cost-effective treatments for secondary prevention of stroke and other non-communicable diseases is a long-term medication regimen. However, the complexities of medication adherence extend far beyond individual behavior change, particularly in low- and middle-income countries. The purpose of this study was to examine stakeholder perspectives on barriers to medication adherence for stroke patients in Beijing, China, identifying opportunities to improve care and policy in resource-constrained settings. METHODS: We conducted a qualitative, phenomenological analysis of data obtained from 36 individuals. Participants were patients; caregivers; healthcare providers; and representatives from industry and government, purposively selected to synthesize multiple perspectives on medication management and adherence for stroke secondary prevention in Beijing, China. Data was analyzed by thematic analysis across iterative coding cycles. RESULTS: Four major themes characterized barriers on medication adherence, across stakeholders and geographies: limitations driven by individual patient knowledge / attitudes; lack of patient-provider interaction time; lack of coordination across the stratified health system; and lack of affordability driven by high overall costs and limited insurance policies. CONCLUSIONS: These barriers to medication management and adherence suggest opportunities for policy reform and local practice changes, particularly for multi-tiered health systems. Findings from this study in Beijing, China could be explored for applicability in other low- and middle-income countries with urban centers serving large geographic regions.

Duke Scholars

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Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

August 12, 2021

Volume

21

Issue

1

Start / End Page

799

Location

England

Related Subject Headings

  • Secondary Prevention
  • Rural Population
  • Qualitative Research
  • Medication Adherence
  • Humans
  • Health Policy & Services
  • Caregivers
  • 4206 Public health
  • 4205 Nursing
  • 4203 Health services and systems
 

Citation

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Xu, J., Zhao, M., Vrosgou, A., Yu, N. C. W., Liu, C., Zhang, H., … Bettger, J. P. (2021). Barriers to medication adherence in a rural-urban dual economy: a multi-stakeholder qualitative study. BMC Health Serv Res, 21(1), 799. https://doi.org/10.1186/s12913-021-06789-3
Xu, Jacqueline, Mengxi Zhao, Athina Vrosgou, Natalie Chin Wen Yu, Chelsea Liu, Han Zhang, Chunxi Ding, et al. “Barriers to medication adherence in a rural-urban dual economy: a multi-stakeholder qualitative study.BMC Health Serv Res 21, no. 1 (August 12, 2021): 799. https://doi.org/10.1186/s12913-021-06789-3.
Xu J, Zhao M, Vrosgou A, Yu NCW, Liu C, Zhang H, et al. Barriers to medication adherence in a rural-urban dual economy: a multi-stakeholder qualitative study. BMC Health Serv Res. 2021 Aug 12;21(1):799.
Xu, Jacqueline, et al. “Barriers to medication adherence in a rural-urban dual economy: a multi-stakeholder qualitative study.BMC Health Serv Res, vol. 21, no. 1, Aug. 2021, p. 799. Pubmed, doi:10.1186/s12913-021-06789-3.
Xu J, Zhao M, Vrosgou A, Yu NCW, Liu C, Zhang H, Ding C, Roth NW, Pan Y, Liu L, Wang Y, Bettger JP. Barriers to medication adherence in a rural-urban dual economy: a multi-stakeholder qualitative study. BMC Health Serv Res. 2021 Aug 12;21(1):799.
Journal cover image

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

August 12, 2021

Volume

21

Issue

1

Start / End Page

799

Location

England

Related Subject Headings

  • Secondary Prevention
  • Rural Population
  • Qualitative Research
  • Medication Adherence
  • Humans
  • Health Policy & Services
  • Caregivers
  • 4206 Public health
  • 4205 Nursing
  • 4203 Health services and systems