“I’m Worth Saving”: Making Sense of Medication Taking in a Care Coordination Organization

ABSTRACT

Patients and healthcare providers (HCPs) may communicatively make sense of medication taking in divergent ways. Often, HCPs prioritize medication adherence, the extent to which patients consume medications as prescribed. In contrast, patients may focus on how medications fit in with their everyday lives. Care coordination organizations (CCOs) provide cohesive, interdisciplinary, health services to chronically ill patients and may help bridge the gap between patient and HCP sensemaking. Our qualitative study asked: How do patients and HCPs involved in a CCO communicatively make sense of medication taking? Through thematic analysis, we found three themes related to patients’ sensemaking. Patients (N = 9) made sense of medication taking (1) as necessary and important through embodied experiences, social discourses, and interpersonal interactions; (2) as easy when supported; and (3) through building bonds. We also found three themes related to HCPs’ sensemaking: HCP participants (N = 5) made sense of medication taking (1) through dialogue with patients; (2) by interacting in patients’ home spaces; and (3) through building relationships with patients. Our final theme explores how communicative sensemaking became more complicated for participants in the context of psychotropic medications. Using Mishler’s Voice of the Lifeworld (VoL) and Weick’s sensemaking, we advance a constitutive perspective on medication taking. We suggest that researchers and HCPs should focus on constructing shared meanings about medication taking through dialogue, rather than on increasing adherence. Our study provides evidence that, by promoting engagement with the VoL, CCOs may facilitate such dialogs.

Acknowledgments

We gratefully acknowledge Dr. Ambar Basu and Dr. Lori Roscoe for their valuable feedback on this manuscript. We also extend our sincerest thanks to all those who participated in this study.

Notes

1. Some scholars use the term “(non)compliance” interchangeably with “(non)adherence.” In this article, we use “(non)adherence,” as this is the term most widely used among health communication scholars. In addition, we use the more general term “medication taking” when discussing how patients and HCPs think, feel, and behave in relation to medications in ways that may or may not directly relate to their orientation toward (non)adherence.

2. Polypharmacy is the use of multiple medications and has been associated with increased medication burden (Sav et al., 2013).

3. Name changed to protect confidentiality

Additional information

Funding

This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1746051. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.