Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.602460
Title: Adherence to treatment in bronchiectasis
Author: McCullough , Amanda Rachel
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2013
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Abstract:
Introduction: Patients with bronchiectasis infected with Pseudomonas aeruginosa are prescribed a complex treatment regimen. Current bronchiectasis guidelines recognise that adherence to treatment is important in this patient group but no published studies have determined the level of adherence to treatment in this population. Therefore, the overall aims of this thesis were to determine rates of adherence to treatment, explore factors influencing adherence to treatment and to determine associations between adherence to treatment and healthcare outcomes amongst patients with bronchiectasis infected with P. aeruginosa. Methods: Two studies were undertaken to meet these aims: a one year prospective study to determine the level of adherence to treatment in patients with bronchiectasis infected with P. aeruginosa and those factors' associated with adherence, and a qualitative study using semi-structured interviews to gain an in-depth understanding of patients' views on adherence to treatment in bronchiectasis. Results: Adherence was measured using self-report and prescription refill history for 75 patients with bronchiectasis infected with P. aeruginosa, recruited from four Trusts, and findings illustrated that between 41 % and 53% of participants were adherent (completed 2::80% of prescribed treatment) to airway clearance and medicines for bronchiectasis, respectively. Age, number of prescribed medicines, Beliefs about Medicines Questionnaire (BMQ) scores and Quality of Life-Bronchiectasis (QOL-B) scores were associated with adherence to treatment, although, the individual factors varied by treatment type. Being categorised as adherent to inhaled antibiotics was associated with a lower pulmonary exacerbation frequency and higher overall total healthcare costs. Four key themes (beliefs about treatment, practicalities of treatment, trust in healthcare professionals and acceptance of disease and treatment) emerged from the qualitative interviews with patients and were used to develop a conceptual model of factors influencing decision-making about adherence to treatment in patients with bronchiectasis. This model described how patients made conscious decisions about adherence to treatment by weighing up a combination of barriers and motivators to adherence for each treatment. Conclusion: Findings indicated that adherence to treatment is a problem in bronchiectasis and that patients made conscious decisions about adherence to treatment. These findings provide the theoretical basis from which to develop an intervention to improve adherence to treatment in patients with bronchiectasis.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.602460  DOI: Not available
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