Introduction
Adherence and compliance are concepts indicative of the current imbalance in clinical encounters which give primacy to the health professionals’ biomedical beliefs concerning how medicines should be used. However, the decision whether or not to take a medicine ultimately lies with the patient. The patient may have a very different set of beliefs about their own illness and the medicines they take. A fundamental concept of concordance is that the patients' are able to share their beliefs, experiences and preferences with healthcare professionals to order improve the quality of care that they receive. This accentuates the necessity for healthcare professionals to address the uniqueness of the individual and consider the context of a person’s life when monitoring medications for people. Attention to patients’ narrative of their medication experiences could provide insight into individual patient’s uniqueness. This study aimed to explore how medication narratives are used by patients when relating their experiences of treatment and care.

Method
Semi-structured interviews with people with hypertension (n=10), whose focus was to explore, in a narrative format, their experiences of hypertension and its management were analysed. First, each narrative was scrutinised, in terms of the approach that the person took to talking about their medicine(s), to determine if there was any chronological change in the way people relate their story of medication. Secondly, the interviews were subjected to thematic analysis regarding any mention of medications, to explore the similarities, differences and contradictions of people’s medication narratives.

Findings
Patients who had recently been diagnosed were concerned with the changes that had occurred to accommodate and assimilate their treatment into their lives. One participant noted that his medication ‘had made him’ more even tempered and as a consequence was experiencing a more social outlook on life. Patients who had been diagnosed for a number of years were more concerned with a perception of self relative to others with the same condition. Being active and able to undertake charity work was so important to one patient that it influenced her decision regarding her compliance with further antihypertensives. Medication-induced impotence was a particular problem for three male participants as it affected their sense of self. Whilst some accepted it passively and continued with their hypertensive treatment, one participant suggested that his compliance to his hypertensive medication ‘varied according to his needs’. 

Conclusions
Exploring a patient’s narrative not only gives insight into the impact of the illness and its treatment on their life and self-identity but also begins to forge a particular type of relationship between healthcare professional and patient. It is important that a patient’s narrative is recognised by healthcare professionals as an integral aspect of practice because of the move towards a more patient-centred care. Attention to patients' narratives has the potential to re-introduce the humanistic dimension into a clinical encounter, redressing the current imbalance. In addition, it has the potential to provide a better understanding of patients and their behaviours, intentions, reasons, rationales and actions.

References

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