Der Einfluss sozialer Faktoren auf den Umgang mit komplexen Medikamentenregimen - Eine explorative Studie zum Medikamentenkonsum in der Gruppe allein lebender, mehrfach erkrankter, alter Frauen

Abstract

The present paper is a contribution to the discussion about social inequality (disparity) within the German health care. In the instance of medication supplement of single living, multiple diseased elderly women - the largest consumer group within this supply segment - the existence of this disparity has been substantiated and its risks have been fleshed out.The effectiveness of medication therapies for the individual but also for an economy of our health care system relies to a high degree on the professional and social competence of the health care players but also on the general conditions in which they work. In many cases the specific socio-demographical and social criteria of the selected patient group are considered insufficient in the interaction, and therefore also in the treatment process. This deficit has a distinct effect on the medicinally over-, under- and inadequate supply.As the international research literature illustrates, difficulties at the level from the health care players are accompanied by problems in the private practice of patients, which in turn contribute to success and failure in mastering a complex medication regime. Reasons for success or failure are rarely singular but a network of mutually interacting factors.Traditional compliance research predominantly focuses on assessing if people act compliant or not. The patients perspective and consequently the question for the reasons of (non-) compliance has been masked out from the context of this research concern. A critical analysis of the concept of compliance gives reasons why the patient�s perspective has been neglected, and why findings hiatuses have outlived. Using the Pierre Bourdieus' theory of practice, the boundaries of compliance research are to be underlined and the necessity of change in direction are to be pointed at.A result of the critical debate on compliance research, in which quantitative research methods dominate, was the choice of qualitative designs. Thus the perception of subjects has been given a protruding rank in the research processes. The data are based on guided interviews with open questions, analysed according to the impartial Hermeneutik, demonstrated in the form of individual case portraits and eventually discussed.The results indicate, that the coverage of complex clinical regimes refer to unconscious and learned behaviour pattern to a profound degree. These vary according to the origin milieu and thereon (?) linked and available resources. Accordingly social factors, which shape the sickness behaviour and the practice with clinical regimes, must understand qualitative structure variables, what excludes a reduction of social factors to the level of socio-demographic features (strata). Only through such a change of perspectives, the context between social factors and medication practice can be disclosed and visualised.