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Forms of trust and polypharmacy among older adults

Published online by Cambridge University Press:  27 April 2020

Alison Ross Open the ORCID record for Alison Ross [Opens in a new window]  and
James Gillett
Alison Ross*
Affiliation:
Department of Health, Aging, and Society, McMaster University, Hamilton, Ontario, Canada
James Gillett
Affiliation:
Department of Health, Aging, and Society, McMaster University, Hamilton, Ontario, Canada
*
*Corresponding author. Email: rossas@mcmaster.ca
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Abstract

This article examines how older adults make decisions about their medications through interconnected axes of trust that operate across social networks. Trust is negotiated by older adults enrolled in a deprescribing programme which guides them through the process of reducing medications to mitigate risks associated with polypharmacy. Habermas’ work on the significance of communicative action in negotiating trust within social relationships informs our analysis, specifically in-depth semi-structured interviews with older adults about their medication use and the role of social networks in managing their health. Participants were age 70+ and experiencing polypharmacy. Our analysis discusses the social nature of medication practices and the importance of social networks for older adults’ decision-making. Their perspective reflects the critique of late-modern society put forward by Habermas. Negotiating trust in pharmaceutical decision-making requires navigating tensions across and between system networks (health-care professionals) and life-world networks (family and friends). This study contributes to our knowledge of how distinct forms of trust operate in different social spheres, setting the context for the way health-care decisions are made across social networks. Our analysis reinforces the need for older adults to engage meaningfully in health-care decision-making such that a convergence between system-world and life-world structures is encouraged. This would improve deprescribing programmes’ efficacy as older adults optimise their medication use and improve overall quality of life.

Keywords

polypharmacydeprescribingolder adultssocial networkstrust
Type
Article
Information
Ageing & Society , Volume 41 , Issue 11 , November 2021 , pp. 2583 - 2598
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Al-Hashar, A, Al-Zakwani, I, Eriksson, T and Al Za'abi, M (2017) Whose responsibility is medication reconciliation: physicians, pharmacists or nurses? A survey in an academic tertiary care hospital. Saudi Pharmaceutical Journal 25, 52–58.CrossRefGoogle ScholarPubMed
Alpert, PT and Gatlin, T (2015) Polypharmacy in older adults. Home Healthcare Now 33, 524–529.CrossRefGoogle ScholarPubMed
Ballantyne, PJ, Mirza, RM, Austin, Z, Boon, HS and Fisher, JE (2011) Becoming old as a ‘pharmaceutical person’: negotiation of health and medicines among ethnoculturally diverse older adults. Canadian Journal on Aging 30, 169–184.CrossRefGoogle ScholarPubMed
Barry, CA, Stevenson, FA, Britten, N, Barber, N and Bradley, CP (2001) Giving voice to the lifeworld. More humane, more effective medical care? A qualitative study of doctor–patient communication in general practice. Social Science and Medicine 53, 487–505.CrossRefGoogle ScholarPubMed
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.CrossRefGoogle Scholar
Britten, N (1996) Lay views of drugs and medicines: orthodox and unorthodox accounts. In Willams SJ and Calnan M (eds), Modern Medicine: Lay Perspectives and Experiences. London: UCL Press, pp. 478–496.Google Scholar
Brody, DS, Miller, SM, Lerman, CE, Smith, DG and Caputo, GC (1989) Patient perception of involvement in medical care. Journal of General Internal Medicine 4, 506–511.CrossRefGoogle ScholarPubMed
Brown, P (2009) The phenomenology of trust: a Schutzian analysis of the social construction of knowledge by gynae-oncology patients. Health, Risk and Society 11, 391–407.CrossRefGoogle Scholar
Brown, PR and Meyer, SB (2015) Dependency, trust and choice? Examining agency and ‘forced options’ within secondary-healthcare contexts. Current Sociology 63, 729–745.CrossRefGoogle Scholar
Brown, P, Alaszewski, A, Swift, T and Nordin, A (2011) Actions speak louder than words: the embodiment of trust by healthcare professionals in gynae-oncology. Sociology of Health and Illness 33, 280–295.CrossRefGoogle ScholarPubMed
Calnan, M and Rowe, R (2008) Trust, accountability and choice. Health, Risk and Society 10, 201–206.CrossRefGoogle Scholar
Canadian Deprescribing Network (CaDeN) (2016) Annual Report. Available at https://deprescribing.org/wp-content/uploads/2015/11/CaDeN_Annual-Report_23Jan2017_EN_WEB.pdf.Google Scholar
Cheraghi-Sohi, S, Jeffries, M, Stevenson, F, Ashcroft, DM, Carr, M, Oliver, K and Rogers, A (2015) The influence of personal communities on the self-management of medication taking: a wider exploration of medicine work. Chronic Illness 11, 77–92.CrossRefGoogle ScholarPubMed
Cohen, D, McCubbin, M, Collin, J and Pérodeau, G (2001) Medications as social phenomena. Health 5, 441–469.CrossRefGoogle Scholar
Dew, K, Chamberlain, K, Hodgetts, D, Norris, P, Radley, A and Gabe, J (2014) Home as a hybrid centre of medication practice. Sociology of Health and Illness 36, 28–43.CrossRefGoogle ScholarPubMed
Farrell, B, Richardson, L, Raman-Wilms, L, de Launay, D, Alsabbagh, MW and Conklin, J (2018) Self-efficacy for deprescribing: a survey for health care professionals using evidence-based deprescribing guidelines. Research in Social and Administrative Pharmacy 14, 18–25.CrossRefGoogle ScholarPubMed
Frank, AW (2015) Notes on Habermas: Lifeworld and System. Available at https://www.arthurwfrank.org/habemas.Google Scholar
Gaspar, CM (1999) Habermas’ Theory of Communicative Action. Philippines Studies 47, 407–425.Google Scholar
Geest, S and Whyte, SR (1989) The charm of medicines: metaphors and metonyms. Medical Anthropology Quarterly 3, 345–367.CrossRefGoogle Scholar
Goold, S (2002) Trust, distrust and trustworthiness. Journal of General Internal Medicine 17, 79–81.CrossRefGoogle ScholarPubMed
Greene, J and Hibbard, JH (2012) Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. Journal of General Internal Medicine 27, 520–526.CrossRefGoogle ScholarPubMed
Greener, I (2003) Patient choice in the NHS: the view from economic sociology. Social Theory and Health 1, 72–89.CrossRefGoogle Scholar
Habermas, J (1987) The Theory of Communicative Action, Vol. 2. Trans. McCarthy, T. Boston, MA: Beacon Press.Google Scholar
Hajjar, ER, Cafiero, AC, and Hanlon, JT (2007) Polypharmacy in elderly patients. American Journal of Geriatric Pharmacotherapy 5, 345–351.CrossRefGoogle ScholarPubMed
Hanlon, JT, Weinberger, M, Samsa, GP, Schmader, KE, Uttech, KM, Lewis, IK, Cowper, PA, Landsman, PB, Cohen, HJ and Feussner, JR (1996) A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with polypharmacy. American Journal of Medicine 100, 428–437.CrossRefGoogle ScholarPubMed
Hawkins, SF, Nickman, NA and Morse, JM (2017) The paradox of safety in medication management. Qualitative Health Research 27, 1910–1923.CrossRefGoogle ScholarPubMed
Kolind, T and Hesse, M (2017) Patient-centred care – perhaps the future of substance abuse treatment. Addiction 112, 465–466.CrossRefGoogle ScholarPubMed
Maggiore, RJ, Gross, CP and Hurria, A (2010) Polypharmacy in older adults with cancer. The Oncologist 15, 507–522.CrossRefGoogle ScholarPubMed
Maher, RL, Hanlon, J and Hajjar, ER (2014) Clinical consequences of polypharmacy in elderly. Expert Opinion on Drug Safety 13, 57–65.CrossRefGoogle ScholarPubMed
Malvini Redden, S, Tracy, SJ and Shafer, MS (2013) A metaphor analysis of recovering substance abusers’ sense making of medication-assisted treatment. Qualitative Health Research 23, 951–962.CrossRefGoogle Scholar
Meyer, SB (2015) Investigations of trust in public and private healthcare in Australia: a qualitative study of patients with heart disease. Journal of Sociology 51, 221–235.CrossRefGoogle Scholar
Meyer, SB and Ward, PR (2013) Differentiating between trust and dependence of patients with coronary heart disease: furthering the sociology of trust. Health, Risk and Society 15, 279–293.CrossRefGoogle Scholar
Meyer, SB, Ward, PR and Jiwa, M (2012) Does prognosis and socioeconomic status impact on trust in physicians? Interviews with patients with coronary disease in South Australia. BMJ Open 2, e001389.CrossRefGoogle ScholarPubMed
Minet, LKR, Lønvig, EM, Henriksen, JE and Wagner, L (2011) The experience of living with diabetes following a self-management program based on motivational interviewing. Qualitative Health Research 21, 1115–1126.CrossRefGoogle Scholar
Moody, L, Nicholls, N, Shamji, H, Bridge, E, Dhanju, S and Singh, S (2018) The person-centred care guidelines: from principle to practice. Journal of Patient Experience 5, 282–288.CrossRefGoogle Scholar
Murphy, TE, Agostini, JV, Van Ness, PH, Peduzzi, P, Tinetti, ME and Allore, HG (2008) Assessing multiple medication use with probabilities of benefits and harms. Journal of Aging and Health 20, 694–709.CrossRefGoogle ScholarPubMed
Nickman, NA (2017) The chorus of user voices: meeting the challenge of patient-reported outcomes from medications. Qualitative Health Research 27, 1907–1909.CrossRefGoogle ScholarPubMed
Reason, B, Terner, M, McKeag, AM, Tipper, B and Webster, G (2012) The impact of polypharmacy on the health of Canadian seniors. Family Practice 29, 427–432.CrossRefGoogle ScholarPubMed
Salt, E and Peden, A (2011) The complexity of the treatment: the decision-making process among women with rheumatoid arthritis. Qualitative Health Research 21, 214–222.CrossRefGoogle ScholarPubMed
Scambler, G and Britten, N (2001) System, lifeworld and doctor–patient interaction: issues of trust in a changing world. In Scambler, G (ed.), Habermas, Critical Theory and Health. London: Routledge, pp. 45–67.Google Scholar
Sholihat, NK, Hanifah, A, Puspaningtyas, MD, Maharani, L and Utami, ED (2018) Medication reconciliation as a tool to reduce medication discrepancy. Journal of Applied Pharmaceutical Science 8, 115–118.Google Scholar
Ward, PR, Coffey, C and Meyer, S (2015) Trust, choice and obligation: a qualitative study of enablers of colorectal cancer screening in South Australia. Sociology of Health and Illness 37, 988–1006.CrossRefGoogle ScholarPubMed