Exploring Patients' and Healthcare Providers' Experiences with Medication Management in Chronic Disease Care: A Qualitative Study Using Semi-Structured Interviews with Adult Patients and Physicians in Urban Primary Care Settings
Main Article Content
Abstract
Medication management is a crucial aspect of chronic disease treatment, yet the subjective experiences of patients and healthcare providers remain underexplored in existing literature. While clinical studies focus on outcomes such as adherence and symptom relief, the emotional and psychological experiences related to medication use are often overlooked. Despite the growing recognition of this gap, little is known about how patients perceive and manage side effects, as well as their interactions with healthcare providers regarding medication. This study employs a phenomenological approach to explore these subjective experiences and aims to provide a deeper understanding of patients’ and healthcare providers’ perspectives. Through semi-structured interviews with 15 participants (10 patients diagnosed with diabetes or hypertension, aged 35–70 years, and 5 healthcare professionals including physicians and pharmacists working in urban primary care clinics), this study reveals that clear communication, emotional support, and understanding of medication side effects are pivotal to improving patient engagement and adherence. Among patients, 9 out of 10 reported experiencing at least one significant side effect (e.g., dizziness, fatigue, or gastrointestinal discomfort), and 7 indicated that insufficient communication from providers exacerbated their anxiety about long-term treatment. Conversely, 4 out of 5 healthcare professionals emphasized time constraints as a major barrier to providing adequate counseling. The findings suggest that addressing emotional burdens, such as concerns over side effects, can enhance medication adherence and patient outcomes. Furthermore, the study highlights the importance of personalized care in fostering trust and improving patient-pharmacist interactions. These results contribute to a more holistic understanding of medication management, emphasizing the need for a patient-centered approach to healthcare. The study underscores not only the qualitative depth of participants’ experiences but also the measurable extent of communication gaps and emotional burden, providing contextual clarity to the challenges faced in chronic disease care. The implications for future research include exploring the role of cultural factors in medication adherence and developing interventions to improve communication and emotional support in healthcare settings.
Article Details
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Axon, D. R., Johnson, M., Abeln, B., Forbes, S., Anderson, E. J., Taylor, A. M., Aseret-Manygoats, T., Warholak, T., & Hall-Lipsy, E. (2022). An Academic-Community Collaboration to Deliver Medication Therapy Management (MTM) Services to Patients Living in Rural Counties of a Southwestern State in the United States. Journal of Pharmacy Practice, 35(5), 691–700. Scopus. https://doi.org/10.1177/08971900211000219
Ayyala-Somayajula, D., Dodge, J. L., Farias, A., Terrault, N., & Lee, B. P. (2023). Healthcare affordability and effects on mortality among adults with liver disease from 2004 to 2018 in the United States. Journal of Hepatology, 79(2), 329–339. Scopus. https://doi.org/10.1016/j.jhep.2023.03.020
Bahrodi, P. S., Safa, A., Ajorpaz, N. M., & Avanji, F. S. I. (2024). Heart failure patients’ experiences of self-care neglect: A content analysis. BMC Cardiovascular Disorders, 24(1). Scopus. https://doi.org/10.1186/s12872-024-04347-3
Caballero, A. E., Ceriello, A., Misra, A., Aschner, P., McDonnell, M. E., Hassanein, M., Ji, L., Mbanya, J. C., & Fonseca, V. A. (2020). COVID-19 in people living with diabetes: An international consensus. Journal of Diabetes and Its Complications, 34(9). Scopus. https://doi.org/10.1016/j.jdiacomp.2020.107671
Coffey, J. D., Christopherson, L. A., Williams, R. D., Gathje, S. R., Bell, S. J., Pahl, D. F., Manka, L., Blegen, R. N., Maniaci, M. J., Ommen, S. R., & Haddad, T. C. (2022). Development and implementation of a nurse-based remote patient monitoring program for ambulatory disease management. Frontiers in Digital Health, 4. Scopus. https://doi.org/10.3389/fdgth.2022.1052408
Dattani, R., Barwick, T. D., El Wardany, G., Gibbons, N., Mason, J. C., Morgan, P., Pusey, C. D., Tam, F. W. K., & Tomlinson, J. A. P. (2022). An international patient-centred study of retroperitoneal fibrosis. QJM: An International Journal of Medicine, 115(3), 148–154. Scopus. https://doi.org/10.1093/qjmed/hcaa327
Davis, S. A., Coyne, I., Carpenter, D. M., Thomas, K. C., Lee, C., Garcia, N., & Sleath, B. (2021). Adolescent Preferences Regarding a Web Site to Empower Adolescents to Talk With Their Healthcare Providers. Journal of Adolescent Health, 68(3), 629–631. Scopus. https://doi.org/10.1016/j.jadohealth.2020.06.032
Dhaliwal, K. K., Watson, K. E., Lamont, N. C., Drall, K. M., Donald, M., James, M. T., Robertshaw, S., Verdin, N., Benterud, E., McBrien, K., Gil, S., Tsuyuki, R. T., Pannu, N., & Campbell, D. J. T. (2023). Managing ‘sick days’ in patients with chronic conditions: An exploration of patient and healthcare provider experiences. Health Expectations, 26(4), 1746–1756. Scopus. https://doi.org/10.1111/hex.13789
Eton, D. T., Linzer, M., Boehm, D. H., Vanderboom, C. E., Rogers, E. A., Frost, M. H., Wambua, M., Vang, M., Poplau, S., Lee, M. K., & Anderson, R. T. (2020). Deriving and validating a brief measure of treatment burden to assess person-centered healthcare quality in primary care: A multi-method study. BMC Family Practice, 21(1). Scopus. https://doi.org/10.1186/s12875-020-01291-x
Garvey, W. T., Mahle, C. D., Bell, T., & Kushner, R. F. (2024). Healthcare professionals’ perceptions and management of obesity & knowledge of glucagon, GLP-1, GIP receptor agonists, and dual agonists. Obesity Science and Practice, 10(3). Scopus. https://doi.org/10.1002/osp4.756
Guedry, S. E., Langley, B. O., Schaefer, K., & Hanes, D. A. (2023). Patient experience of chronic illness care and complementary integrative health use: A cross-sectional study of patients with hypermobility spectrum disorders (HSD) and Ehlers–Danlos syndromes (EDS). Disability and Rehabilitation, 45(21), 3549–3559. Scopus. https://doi.org/10.1080/09638288.2022.2131003
Jankowska-Polańska, B., Sapilak, B., Kałuska, M., Mazurek, T., Oen, J., Janusz, A., & Tański, W. (2024). Challenges and opportunities in the Polish healthcare sector from the implementation of telemedicine solutions in the field of gerontology and geriatric medicine: Own experience. Wiadomosci Lekarskie (Warsaw, Poland : 1960), 77(7), 1505–1513. Scopus. https://doi.org/10.36740/WLek202407128
Johnson, B. (2014). Educational research: Quantitative, qualitative, and mixed approaches (Fifth edition). Sage Publications.
Karia, A., Thomas, L., Webster, R., Sim, T. F., Norman, R., & Robinson, S. (2025). Consumer perceptions and preferences of pharmacist-led professional services and attributes in Australia: A qualitative focus group study. BMJ Open, 15(6). Scopus. https://doi.org/10.1136/bmjopen-2025-101049
Kelly, D., Koay, A., Mineva, G., Volz, M., McCool, A., McLoughlin, E., Ó Conluain, R., Sharma, M., Kerr, A., Franklin, B. D., & Grimes, T. (2023). A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies. Public Health, 214, 50–60. Scopus. https://doi.org/10.1016/j.puhe.2022.10.026
Leavy, P. (Ed.). (2014). The Oxford handbook of qualitative research. Oxford University Press.
Li, Y., Barve, K., Cockrell, M., Agarwal, A., Casebeer, A., Dixon, S. W., & Poonawalla, I. (2023). Managing comorbidities in chronic kidney disease reduces utilization and costs. BMC Health Services Research, 23(1). Scopus. https://doi.org/10.1186/s12913-023-10424-8
Livingston, K. A., Freeman, K. J., Friedman, S. M., Stout, R. W., Lianov, L. S., Drozek, D., Shallow, J., Shurney, D., Patel, P. M., Campbell, T. M., Pauly, K. R., Pollard, K. J., & Karlsen, M. C. (2021). Lifestyle medicine and economics: A proposal for research priorities informed by a case series of disease reversal. International Journal of Environmental Research and Public Health, 18(21). Scopus. https://doi.org/10.3390/ijerph182111364
Macklin, J., Samson, B., Zsager, A., Ross, H., Pinto, A., & Gibson, J. L. (2024). Cardiovascular disease management and healthcare delivery for people experiencing homelessness: A scoping review. BMC Health Services Research, 24(1). Scopus. https://doi.org/10.1186/s12913-024-11503-0
Morin, C. M., Khullar, A., Robillard, R., Desautels, A., Mak, M. S. B., Dang-Vu, T. T., Chow, W., Habert, J., Lessard, S., Alima, L., Ayas, N. T., MacFarlane, J., Kendzerska, T., Lee, E. K., & Carney, C. E. (2024). Delphi consensus recommendations for the management of chronic insomnia in Canada. Sleep Medicine, 124, 598–605. Scopus. https://doi.org/10.1016/j.sleep.2024.09.038
Natarajan, J., Joseph, M. A., Al Alawi, R., Al Bulushi, T., Al Alawi, I., Al Junaibi, S. M., Thanka, A. N., Al Balushi, L. D., Al Ismaili, I. S., Shummo, M., & Al Nabhani, S. S. T. (2024). A domain specific health-related quality of life of omani patients living with chronic wounds. Journal of Tissue Viability, 33(3), 393–398. Scopus. https://doi.org/10.1016/j.jtv.2024.05.004
Orenstein, L. A. V., Salame, N., Siira, M. R., Urbanski, M., Flowers, N. I., Echuri, H., Garg, A., Mckenzie-Brown, A. M., Curseen, K. A., Patzer, R. E., Kavalieratos, D., & Chen, S. C. (2023). Pain experiences among those living with hidradenitis suppurativa: A qualitative study. British Journal of Dermatology, 188(1), 41–51. Scopus. https://doi.org/10.1093/bjd/ljac018
Overbury, R. S., Huynh, K., Bohnsack, J., Frech, T., & Hersh, A. (2021). A novel transition clinic structure for adolescent and young adult patients with childhood onset rheumatic disease improves transition outcomes. Pediatric Rheumatology, 19(1). Scopus. https://doi.org/10.1186/s12969-021-00651-w
Padgett, D. (2017). Qualitative methods in social work research (Third edition). SAGE.
Rafii, F., Alinejad-Naeini, M., Soleymani Babadi, A., Shahriari, E., & Heidari Beni, F. (2024). Facilitators and barriers to self-management in Iranian men with chronic obstructive pulmonary disease: A qualitative study. BMJ Open Respiratory Research, 11(1). Scopus. https://doi.org/10.1136/bmjresp-2023-002245
Rao, Q., Zeng, J., Wang, S., Hao, J., & Jiang, M. (2022). Chronic Pain and Quality of Life in Maintenance Hemodialysis Patients in China: A Multicenter, Cross-Sectional Study. Journal of Pain Research, 15, 147–157. Scopus. https://doi.org/10.2147/JPR.S345610
Rendrayani, F., Alfian, S. D., Wahyudin, W., & Puspitasari, I. M. (2023). Knowledge, attitude, and practice of medication therapy management: A national survey among pharmacists in Indonesia. Frontiers in Public Health, 11. Scopus. https://doi.org/10.3389/fpubh.2023.1213520
Santos, B., Blondon, K. S., Van Gessel, E., Cerutti, B., Backes, C., Locher, S., Guignard, B., Bonnabry, P., Carpenter, D., & Schneider, M. P. (2022). Patients’ perceptions of conflicting information on chronic medications: A prospective survey in Switzerland. BMJ Open, 12(11). Scopus. https://doi.org/10.1136/bmjopen-2021-060083
Sanya, R. E., Karugu, C. H., Binyaruka, P., Mohamed, S. F., Kisia, L., Kibe, P., Mashasi, I., Mhalu, G., Bunn, C., Deidda, M., Mair, F. S., Grieve, E., Gray, C. M., Mtenga, S., & Asiki, G. (2024). Impact of the COVID-19 pandemic on type 2 diabetes care and factors associated with care disruption in Kenya and Tanzania. Global Health Action, 17(1). Scopus. https://doi.org/10.1080/16549716.2024.2345970
Shayo, E. H., Murdoch, J., Kiwale, Z., Bachmann, M., Bakari, M., Mbata, D., Masauni, S., Kivuyo, S., Mfinanga, S., Jaffar, S., & Van Hout, M.-C. (2023). Management of chronic conditions in resource limited settings: Multi stakeholders’ perception and experiences with receiving and providing integrated HIV, diabetes and hypertension services in Tanzania. BMC Health Services Research, 23(1). Scopus. https://doi.org/10.1186/s12913-023-10123-4
Starling, A. J., Cady, R., Buse, D. C., Buzby, M., Spinale, C., Steinberg, K., Lenaburg, K., & Kymes, S. (2024). Harris Poll Migraine Report Card: Population-based examination of high-frequency headache/migraine and acute medication overuse. Journal of Headache and Pain, 25(1). Scopus. https://doi.org/10.1186/s10194-024-01725-2
Stømer, U. E., Wahl, A. K., Gøransson, L. G., & Urstad, K. H. (2020). Exploring health literacy in patients with chronic kidney disease: A qualitative study. BMC Nephrology, 21(1). Scopus. https://doi.org/10.1186/s12882-020-01973-9
Sweileh, W. M. (2024). Analysis and mapping the research landscape on patient-centred care in the context of chronic disease management. Journal of Evaluation in Clinical Practice, 30(4), 638–650. Scopus. https://doi.org/10.1111/jep.13988
Tahsin, F., Doody, P., Clyne, B., Kiely, B., Moriarty, F., Gillespie, P., Kenny, E., Boland, F., Byrne, M., O’Connor, L., Murphy, A. W., & Smith, S. M. (2025). Medicines support and social prescribing to address patient priorities in multimorbidity (MIDAS): Protocol for a definitive, multi-arm, cluster randomised, controlled trial in Irish general practice. BMJ Open, 15(6). Scopus. https://doi.org/10.1136/bmjopen-2025-101315
van de Graaf, D. L., Mols, F., Smeets, T., Trompetter, H. R., & van der Lee, M. L. (2025). Coping with and self-management of chronic painful chemotherapy-induced peripheral neuropathy: A qualitative study among cancer survivors. Journal of Cancer Survivorship, 19(1), 295–305. Scopus. https://doi.org/10.1007/s11764-023-01466-2
Warniment, A., Sauers-Ford, H., Brady, P. W., Beck, A. F., Callahan, S. R., Giambra, B. K., Herzog, D., Huang, B., Loechtenfeldt, A., Loechtenfeldt, L., Miller, C. L., Perez, E., Riddle, S. W., Shah, S. S., Shepard, M., Sucharew, H. J., Tegtmeyer, K., Thomson, J. E., & Auger, K. A. (2023). Garnering effective telehealth to help optimize multidisciplinary team engagement (GET2HOME) for children with medical complexity: Protocol for a pragmatic randomized control trial. Journal of Hospital Medicine, 18(10), 877–887. Scopus. https://doi.org/10.1002/jhm.13192
White-Williams, C., Rossi, L. P., Bittner, V. A., Driscoll, A., Durant, R. W., Granger, B. B., Graven, L. J., Kitko, L., Newlin, K., & Shirey, M. (2020). Addressing Social Determinants of Health in the Care of Patients with Heart Failure: A Scientific Statement from the American Heart Association. Circulation, 141(22), e841–e863. Scopus. https://doi.org/10.1161/CIR.0000000000000767
Wong, M. S., Luger, T. M., Katz, M. L., Stockdale, S. E., Ewigman, N. L., Jackson, J. L., Zulman, D. M., Asch, S. M., Ong, M. K., & Chang, E. T. (2021). Outcomes that Matter: High-Needs Patients’ and Primary Care Leaders’ Perspectives on an Intensive Primary Care Pilot. Journal of General Internal Medicine, 36(11), 3366–3372. Scopus. https://doi.org/10.1007/s11606-021-06869-4
Yaacoby-Bianu, K., Cohen-Cymberknoh, M., Shoseyov, D., Lavi, T., Ostrovski, A., Shteinberg, M., & Livnat, G. (2023). Optimizing CFTR modulator therapy management for cystic fibrosis through the ReX platform. Frontiers in Pediatrics, 11. Scopus. https://doi.org/10.3389/fped.2023.1300968
Yadav, U. N., Lloyd, J., Hosseinzadeh, H., Baral, K. P., Dahal, S., Bhatta, N., & Harris, M. F. (2020). Facilitators and barriers to the self-management of COPD: A qualitative study from rural Nepal. BMJ Open, 10(3). Scopus. https://doi.org/10.1136/bmjopen-2019-035700
Yang, C., Hui, Z., Zeng, D., Zhu, S., Wang, X., Lee, D. T. F., & Chair, S. Y. (2021). A community-based nurse-led medication self-management intervention in the improvement of medication adherence in older patients with multimorbidity: Protocol for a randomised controlled trial. BMC Geriatrics, 21(1). Scopus. https://doi.org/10.1186/s12877-021-02097-x