Medication-taking behaviours in chronic kidney disease with multiple chronic conditions: a meta-ethnographic synthesis of qualitative studies

Rebecca Ellis, Janet Welch

Research output: Contribution to journalReview article

8 Scopus citations


Aims and objectives: To identify behaviours associated with taking medications and medication adherence reported in qualitative studies of adults with chronic kidney disease and coexisting multiple chronic conditions. Background: To inform medication adherence interventions, information is needed to clarify the nature of the relationships between behaviours that support medication-taking and medication adherence in multiple chronic conditions. Design: Meta-ethnographic review and synthesis. Methods: CINAHL Complete, MEDLINE and PsycINFO databases were searched. Five qualitative studies met the inclusion criteria. A meta-ethnographic approach was used for synthesis. Medication-taking behaviours were abstracted from study findings and synthesised according to the contexts in which they occur and interpreted within a new developing framework named the Medication-taking Across the Care Continuum and Adherence-related Outcomes. Results: Twenty categories of medication-taking behaviours occurred in three main contexts: (1) patient–provider clinical encounters, (2) pharmacy encounters and (3) day-to-day management. These behaviours are distinctly different, multilevel and interrelated. Together they represent a process occurring across a continuum. Conclusions: Future medication adherence research should consider using a multilevel ecological view of medication management. Clinical practice and policy development can benefit from further understanding socio-contextual behaviours that occur across the continuum. Nurses should have greater presence in chronic disease management and be positioned to support the day-to-day home management of patients' medications. Relevance to clinical practice: Healthcare professionals can partner with patients to elucidate how these behaviours are enacted across the care continuum and in day-to-day management to identify opportunities to intervene on specific behaviours and promote medication adherence.

Original languageEnglish (US)
Pages (from-to)586-598
Number of pages13
JournalJournal of Clinical Nursing
Issue number5-6
StatePublished - Mar 1 2017


  • behaviour
  • chronic illness
  • comorbidity
  • compliance
  • medication adherence
  • medication management
  • self-management

ASJC Scopus subject areas

  • Nursing(all)

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