[Adverse events with oral anticoagulants].

Anticoagulant therapy is widely used for prevention and treatment of cardiovascular disease and is frequently prescribed both in primary and secondary care. In comparison to other drugs, the frequency of medication errors is high for anticoagulant therapy. In Denmark, 4,383 adverse events with vitamin K antagonists and 3,234 adverse events with non-vitamin K antagonist oral anticoagulants were reported to the Danish Patient Safety Authority in 2014-2017. In this review, we provide an overview of medication errors and discuss frequent adverse events and pitfalls.

Development of new concepts of non-adherence measurements among users of antihypertensives medicines.

OBJECTIVE: To identify various types of non-adherence among users of antihypertensive medications by establishing components of adherence measures and use these components for measuring the prevalence of non-adherence. SETTING: Twelve community pharmacies from the Danish county of Funen. METHOD: Users of antihypertensive medication were included in the study. 2,914 medication users received questionnaires by mail. Participating patients were asked to fill in two questionnaire regarding demographics, self-reported blood pressure, and various adherence measures. Two factor analyses were conducted based on responses to questions. MAIN OUTCOME MEASURES: Medication-taking behaviour and self-efficacy (beliefs about ability and capacity to accomplish a task), respectively. Other measures of non-adherence collected by questionnaire were also addressed in the data for comparison of prevalence with the developed concepts. RESULTS: 1,426 (49%) participants answered the questionnaires. The analyses resulted in two sets of components: three adherence behaviour measures and two self-efficacy measures which showed similarities in concepts. The adherence behaviour measures included two concepts of intentional nonadherence (associated with aspects of self-regulation and effect concerns, respectively) and one measure of non-intentional non-adherence. Prevalence of the developed measures of behaviour related non-adherence ranged from 10.3 to 34.9% depending on which type of non-adherence measure was used. Established measures of non-adherence resulted in prevalence between 2.2 and 39.6%. CONCLUSIONS: The study showed that concepts of non-adherence measurements could be determined including self-efficacy aspects, unintentional non-adherence and intentional non-adherence related to self-regulation and effect concerns respectively. The prevalence of the adherence behaviour components were found to be between 10.3 and 34.9%, which is in the range of expected values. Associations between the new concepts of non-adherence measurement and characteristics of nonadherers remain to be established and would be a subject for further studies.

Discourses of agency and the search for the authentic self: the case of mood-modifying medicines.

It is well established in the literature that people are active decision makers in relation to help seeking and medicine taking. This paper uses data from two qualitative studies that focused on mood-modifying medicines to illustrate how active engagement, demonstrated through help seeking and decisions about treatment, was perceived to be a crucial part of recovery. Data were generated from semi-structured interviews with 23 men and women in the UK and 12 women in Denmark. We argue that being active in decisions relating to help seeking and medicine taking for problems with mood is perceived as central in order to (re)find an 'authentic' sense of self. There is, however, an inherent contradiction in the fact that the majority of the respondents believed medicine taking to be necessary, yet the act of taking a mood-modifying medicine was in most cases perceived as a potential threat to agency and ultimately the achievement of an authentic self.

Leading ordinary lives: a qualitative study of younger women's perceived functions of antidepressants.

BACKGROUND: While the overall consumption of psychotropic medicines such as tranquillisers and hypnotics has declined, the consumption of the newer antidepressants--selective serotonin reuptake inhibitors (SSRIs) has increased drastically since their introduction. In order to understand the mechanisms underlying the use, it is important to gain insight into the users' perceptions about their medicine and use. OBJECTIVE: To analyse younger women's perceived functions of SSRIs in their everyday lives. METHODS: 12 in-depth interviews and 6 re-interviews were conducted with a community-based sample of 21- to 34-year-old women taking SSRIs. The women were recruited through Danish pharmacies. RESULTS: Prior to taking SSRIs the women struggled with their emotional problems, often in great frustration and distress. While taking SSRIs the women experienced that the medicine functioned both at a psychological and a social level. They believed that the medicine gave them resources to behave actively in a way that was not previously possible. They felt that the medicine use enabled them to concentrate on daily life activities other than dealing solely with their emotional problems. The women found that the medicine gave them back a sense of 'normality'. CONCLUSION: The main finding in this paper is that the perceived functions of SSRIs were related to social meanings and goals in everyday life.

Changes in self-concept while using SSRI antidepressants.

In this study, the authors analyze how younger women see themselves within the context of using the antidepressants selective serotonin re-uptake inhibitors (SSRIs). Twelve in-depth interviews and 6 reinterviews were conducted with a community-based sample of women who had been taking SSRIs between 1 and 4 years. The empirical analysis revealed that SSRI users passed through stages in their careers as medicine users, these stages corresponding to how the users thought and felt about themselves. Four major changes in self-concept emerged: distressed and needing help, conflicts about taking the medicine, improvements in condition, and problems discontinuing the medicine. Users evaluated themselves from what they believed was the perspective of society, and the way they saw themselves was closely related to how they felt they functioned in everyday life.