Adults with multiple chronic conditions (MCCs) often face difficulties with medication management, affecting their experiences of well-being and illness. The objective of this study was to identify and describe the occupational experiences of medication management and their impact on well-being and illness in adults living with MCCs. We used document analysis methods to analyze 134 illness narrative blog posts authored by 52 adults aged 18 and older with MCCs. Content and thematic analysis of their textual content was based on the Pan Occupational Paradigm. Medication management is enacted through the dimensions of doing, belonging, becoming, being, and knowing, in an interconnected, nonlinear manner, with a more notable impact on illness than well-being due to the complexities associated with medication management for MCCs. Occupational therapy practices for medication management should consider all occupational dimensions and their impact on health rather than focusing primarily on the performance of medication tasks and routines.
AdamsM. L. (2017). Differences between younger and older US adults with multiple chronic conditions. Preventing Chronic Disease: Public Health Research, Practice, and Policy, 14, Article E76. https://doi.org/10.5888/pcd14.160613
2.
AldrichR. M. (2011). A review and critique of well-being in occupational therapy and occupational science. Scandinavian Journal of Occupational Therapy, 18(2), 93–100. https://doi.org/10.3109/11038121003615327
3.
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). The American Journal of Occupational Therapy, 74(Suppl. 2), Article 7412410010. https://doi.org/10.5014/ajot.2020.74S2001
4.
AtlerK. (2015). An argument for a dynamic interrelated view of occupational experience. Journal of Occupational Science, 22(3), 249–259. https://doi.org/101080/14427591.2014.887991
5.
BajcarJ. (2006). Task analysis of patients’ medication-taking practice and the role of making sense: A grounded theory study. Research in Social and Administrative Pharmacy, 2, 59–82. https://doi.org/10.1016/j.sapharm.2005.12.005
6.
BissellP.RyanK.MorecroftC. (2006). Narratives about illness and medication: A neglected theme/new methodology within pharmacy practice research. Part I: Conceptual framework. Pharmacy World Science, 28, 54–60. https://doi.org/10.1007/s11096-006-9005-y
7.
BoersmaP.BlackL. I.WardB. W. (2020). Prevalence of multiple chronic conditions among US adults. Preventing Chronic Disease, 17, Article 200130. https://doi.org/10.5888/ped17.200130
8.
BowenG. A. (2009). Document analysis as a qualitative research method. Qualitative Research Journal, 9(2), 27–40. https://doi.org/10.3316/QRJ0902027
9.
BraunV.ClarkeV. (2013). Successful qualitative research: A practical guide for beginners. SAGE.
CameronJ. E.VothJ.JaglalS. B.GuilcherS. J. T.HawkerG.SalbachN. M. (2018). “In this together”: Social identification predicts health outcomes (via self-efficacy) in a chronic disease self-management program. Social Science & Medicine, 208, 172–179. https://doi.org/10.1016/j.socscimed.2018.03.007
12.
ChengC.InderK.ChanS. W. C. (2019). Patients’ experiences of coping with multiple chronic conditions: A meta-ethnography of qualitative work. International Journal of Mental Health Nursing, 28(1), 54–70. https://doi.org/10.1111/ihm.12544
13.
ConnV. S.RupparT. M. (2017). Medication adherence outcomes of 771 intervention trials: Systematic review and meta-analysis. Preventive Medicine, 99, 269–276. https://doi.org/10.1016/j.ypmed.2017.03.008
14.
CrossA. J.ElliottR. A.PetrieK.KuruvillaL.GeorgeJ. (2020). Interventions for improving medication-taking ability and adherence in older adults prescribed multiple medications (review). Cochrane Database of Systematic Reviews, 5, Article CD012419. https://doi.org/10.1002.14651858.CD012419.pub2
15.
EasthamL. A. (2011). Research using blogs for data: Public documents or private musings?Research in Nursing and Health, 34, 353–361. https://doi.org/10.1002/nur.20443
16.
EriksenC. U.KyriakidisS.ChristensenL. D.JacobsenR.LaursenJ.ChristensenM. B.FrolichA. (2020). Medication-related experiences of patients with polypharmacy: A systematic review of qualitative studies. BMJ Open Journal, 10, Article e036158. https://doi.org/10.1136/bmjopen-2019-036158
17.
FrancisH.CaryerJ.WilkinsonJ. (2019). Patient expertise: Contested territory in the realm of long-term condition care. Chronic Illness, 15(3), 197–209. https://doi.org/10.1177/1742395318757853
18.
FredericksenR. J.GibbonsL.BrownS.EdwardsT. C.YangF. M.FitzsimmonsE.Alperovitz-BichellK.GodfreyM.WangA.ChurchA.GutierrezC.PaezE.DantL.LooS.WalcottM.MugaveroM. J.MayerK.MathewsW. C.PatrickD. L.. . . CraneH. M. (2018). Medication understanding among patients living with multiple chronic conditions: Implications for patient-reported measures of adherence. Research in Social and Administrative Pharmacy, 14, 540–544. https://doi.org/10.1016/j.sapharm.2017.06.009
19.
GerlachA. J.TeachmanG.Laliberte-RudmanD.AldrichR. M.HoutS. (2018). Expanding beyond individualism: Engaging critical perspectives on occupation. Scandinavian Journal of Occupational Therapy, 25(1), 35–43. https://doi.org/10.1080/11038128.2017.1327616
20.
HajatC.SteinE. (2018). The global burden of multiple chronic conditions: A narrative review. Prevention Medicine Reports, 12, 284–293. https://doi.org/10.1016/jmedr.2018.10.008
21.
HammellK. W. (2009). Self-care, productivity, and leisure, or dimensions of occupational experience? Rethinking occupational categories. Canadian Journal of Occupational Therapy, 76(2), 107–114. https://doi.org/10.1177/000841740907600208
22.
HammellK. W. (2014). Belonging, occupation, and human well-being: An exploration. Canadian Journal of Occupational Therapy, 81(1), 39–50. https://doi.org/10.1177/0008417413520489
23.
Haynes-LawrenceD.WestA. R. (2018). Managing fatigue in parents with multiple sclerosis. Journal of Child and Family Studies, 27, 1640–1649. https://doi.org/10.1007/s10826-017-1997-y
24.
HeyenN. B.GardeckiJ.Eidt-KochD.SchlangenM.PaulyS.EickmeierO.WagnerT.BratanT. (2022). Patient science: Citizen science involving chronically ill people as co-researchers. Journal of Participatory Research Methods, 3(1), 1–24. https://doi.org/10.35844/001c.35634
25.
HitchD.PepinG.StagnittiK. (2014). In the footsteps of Wilcock, part one: The evolution of doing, being, becoming, and belonging. Occupational Therapy in Healthcare, 28(3), 231–246. https://doi.org/10.3109/07380577.2014.898114
26.
HitchD.PepinG.StagnittiK. (2018). The pan occupational paradigm: Development and key concepts. Scandinavian Journal of Occupational Therapy, 25(1), 27–34. https://doi.org/10.1080/11038128.2017.1337808
27.
HookwayN. (2008). “Entering the blogosphere”: some strategies for using blogs in social research. Qualitative Research, 8(1), 91–113. https://doi.org/10.1177/1468794107085298
28.
JamesK. A.EverallA. C.CadelL.McCarthyL. M.LoftersA.ThompsonA.GuilcherS. J. T. (2022). Exploring medication self-management in community dwelling adults with chronic medication experience: A concept mapping study. Research in Social and Administrative Pharmacy, 18, 2854–2866. https://doi.org/10.1016/j.sapharm.2021.07.001
29.
KesslerM. M. (2022). Stigma stories: Rhetoric, lived experience, and chronic illness. Ohio State Press.
30.
LelandN. E.FogelbergD. J.HalleA. D.MrozT. M. (2017). Occupational therapy and management of multiple chronic conditions in the context of health care reform. The American Journal of Occupational Therapy, 71(1), Article 7101090010. https://doi.org/10.5014/ajot.2017.711001
MohammedM. A.MolesR. J.ChenT. F. (2016). Medication-related burden and patients’ lived experience with medicine: A systematic review and metasynthesis of qualitative studies. BMJ Open, 6, Article e010035. https://doi.org/10.1136/bmjopen-2015-010035
33.
MunroM.CookA. M.BogartK. R. (2022). An inductive qualitative content analysis of stigma experienced by people with rare diseases. Psychology & Health, 37(8), 948–963. https://doi.org/10.1080/08870446.2021.1912344
34.
NascimentoY. A.Ramalho-de-OliveiraD. (2021). The subjective experience of using medications: What we know and the paths forward. Pharmacy, 9, Article 50. https://doi.org/10.3390/pharmacy9010050
35.
NascimentoY. A.SilvaL. D.Ramalho-de-OliveiraD. (2020). Experiences with the daily use of medication among chronic hepatitis C patients. Research in Social and Administrative Pharmacy, 16, 33–40. https://doi.org/10.1016/jpharm.2019.01.018
36.
NwadiugwuM. C. (2021). Multi-morbidity in the older person: An examination of polypharmacy and socioeconomic status. Frontiers in Public Health, 8, 582234. https://doi.org/10.3389/fpubh.2020.582234
37.
O’BrienB. C.HarrisI. B.BeckmanT. J.ReedD. A.CookD. A. (2014). Standards for reporting qualitative research: A synthesis of recommendations. Academic Medicine, 89(9), 1245–1251. https://doi.org/10.1097/ACM.0000000000000388
38.
O’DonnellA. T.HabenichtA. E. (2022). Stigma is associated with illness self-concept in individuals with concealable chronic illnesses. British Journal of Health Psychology, 27, 136–158. https://doi.org/1111.bjhp.12534
39.
PetersL. A.BrownE. M. (2022). The relationship between illness identity and the self-management of inflammatory bowel disease. British Journal of Health Psychology, 27, 956–970. https://doi.org/10.1111/bjhp.12584
RathboneA. P.JamieK.ToddA.HusbandA. (2021). A qualitative study exploring the lived experience of medication use in different disease states: Linking experiences of disease symptoms to medication adherence. Clinical Pharmacy and Therapeutics, 46, 352–362. https://doi.org/10.1111/jcpt.13288
42.
RoebuckM. C.KaestnerR. J.DoughertyJ. S. (2018). Impact of medication adherence on health services utilization in Medicaid. Medical Care, 56(3), 266–273. https://doi.org/10.1097/MLR.0000000000000870
43.
SandersM. J.Van OssT. (2013). Using daily routines to promote medication adherence in older adults. American Journal of Occupational Therapy, 67, 91–99. https://doi.org/10.5014/ajot.2013.005033
44.
SeibertC.SchwartzJ. (2017). Occupational therapy’s role in medication management. The American Journal of Occupational Therapy, 71(Suppl. 2), Article 7112410025. https://doi.org/10.5014/ajot716S02
45.
TaleroP. (2020). Diverse perspectives of health and disability through an occupational lens. In AlvarezL.CoppolaS.BarrettK. (Eds.), International occupational therapy (pp. 57–71). AOTA Press.
46.
TaleroP.KernS.TupeD. A. (2015). Culturally responsive care in occupational therapy: An entry-level educational model in service-learning. Scandinavian Journal of Occupational Therapy, 22(2), 95–102. https://doi.org/10.3109/11038128.2014.997287
47.
TownsendE.WilcockA. A. (2004). Occupational justice and client-centred practice: A dialogue in progress. Canadian Journal of Occupational Therapy, 2(71), 75–87. https://doi.org/10.1177/000841740407100203
WilsonE.KennyA.Dickson-SwiftV. (2015). Using blogs as a qualitative health research tool: A scoping review. International Journal of Qualitative Methods, 14, 1–12. https://doi.org/10.1177/1609406915618049
