Experiences of Polypharmacy Management among Patients with Multiple Chronic Diseases in Uttaradit Province

Abstract

     This qualitative study aimed to explore medication management experiences among patients with multiple chronic diseases living in the community, Uttaradit Province, Thailand. Interpretive Phenomenological Analysis (IPA) was employed as the research methodology. Fourteen participants were purposively recruited based on having two or more chronic conditions and taking five or more medications daily. Data were collected through semi-structured in-depth interviews and analyzed using the six-step IPA process. Trustworthiness was established according to Lincoln and Guba's criteria.

     The results revealed that four super-ordinate themes emerged from the analysis: 1) burden and challenges in medication management, encompassing regimen complexity, side effects disrupting daily life, and economic burden; 2) perceptions and attitudes toward medications, comprising gradual acceptance, concerns about long-term effects, and reliance on traditional folk medicine beliefs; 3) self-management strategies, revealing patients' creativity and autonomous decision-making in daily medication practices; and 4) support networks and interactions with the health system, highlighting the critical roles of family support, relationships with healthcare professionals, and access barriers in rural contexts.

     These findings demonstrate that medication management constitutes an active, multidimensional process embedded in patients' lived realities. Nurses should integrate assessment of patients' medication management experiences within real-life contexts into nursing practice, thereby advancing rational drug use at the community level.