Der Prozess des Medikamentenselbstmanagements: Eine Modellrevision auf Basis einer qualitativen Sekundäranalyse

Background: For safe and effective use of medication, specific skills are required which are inherent in the concept of medication self-management. In order to provide adequate counseling, it is important for registered nurses, physicians and pharmacists to know how medication self-management works in everyday life for the people affected. This process was presented in 2013 in a first conceptual model by Bailey et al. Aim: The purpose of this study was to enhance the empirical foundation of the existing model and to gain an in-depth theoretical understanding of the process of medication self-management. Method: A qualitative secondary analysis was conducted based on data from a semi-standardized survey (n = 395) of people in Austria, who regularly take medicine. The data were analysed according to the structuring content analysis. Results: The extended model shows a new kind of logic. While the steps "fill", "take", "monitor"and "react"are always conducted one after the other, "integrate"and "maintain"form components that are mutually dependent and start after successfully completing the first four steps. "Understand"is a component that influences all steps. The whole process is influenced by personal, socio-economic, disease and medication-related factors, by supportive systems and by the overall health care system. Conclusions: Based on the present study, the drug self-management process is a complex, multi-layered and iterative one. In the context of counselling, it is important to focus on "understanding"at every step.