Routines in medication management: the perspective of people with chronic conditions

Objective: To focus on the challenges and problems of medication management in everyday life experienced by people with chronic conditions, giving special attention to chronic illness trajectories. Methods: Using a grounded theory approach, in-depth and follow-up interviews with 27 chronically ill people were conducted and analysed. Results: From the perspective of people with chronic conditions, the main challenge in everyday medication management was to develop, maintain, and adjust routines. Routines were affected by the chronic illness trajectory and a variety of barriers. Developing and adjusting routines was further complicated by inadequate information and counselling, asymmetric relationships and communication with healthcare professionals, restrictive healthcare conditions, increasing complexities in medication regimens as well as healthcare professionals' lack of interest in the problems of chronically ill people balancing their chronic condition and medication regimen in everyday life. Discussion: Chronically ill persons have to deal with numerous difficulties in everyday medication management on their own. They are often overwhelmed by problems related to both their medication regimen and their routines in medication (self-) management. Thus, they require individualized long-term self-management support. Future research should address the dynamic nature of chronic illness trajectories and focus on later phases of chronic conditions.