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Hesitancy Regarding Medical Advice on COVID-19: An Emergency Department Perspective

Published online by Cambridge University Press:  20 January 2022

Sarper Yilmaz Open the ORCID record for Sarper Yilmaz [Opens in a new window] ,
Figen Ünal Çolak Open the ORCID record for Figen Ünal Çolak [Opens in a new window] ,
Nihat Müjdat Hökenek  and
Rohat Ak Open the ORCID record for Rohat Ak [Opens in a new window]
Sarper Yilmaz
Affiliation:
Department of Emergency Medicine, Kartal Dr Lütfi Kırdar City Hospital, Istanbul, Turkey
Figen Ünal Çolak
Affiliation:
Faculty of Communication Science, Anadolu University, Eskişehir, Turkey
Nihat Müjdat Hökenek
Affiliation:
Department of Emergency Medicine, Kartal Dr Lütfi Kırdar City Hospital, Istanbul, Turkey
Rohat Ak*
Affiliation:
Department of Emergency Medicine, Kartal Dr Lütfi Kırdar City Hospital, Istanbul, Turkey
*
Corresponding author: Rohat Ak, Email: [email protected].
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Abstract

Objective:

The rejection of or non-compliance with treatment arises for different reasons by patients who receive treatment recommendations for various diseases. These states are described by various concepts, such as discharge against medical advice (DAMA) and medication nonadherence (MNA). The basis of the study is to determine how these states have arisen during the coronavirus disease (COVID-19) pandemic.

Method:

The data of this study were collected through standardized interviews with 103 volunteer participants who were diagnosed with COVID-19 at different times and who did not use their prescribed medicine during the pandemic in Turkey. The data obtained in the research were analyzed through the MAXQDA qualitative analysis program.

Results:

As a result of the analysis of the data, 4 main themes and sub-codes have been reached: (1) prescribed medicine, (2) an information source for the COVID-19 period/treatment, (3) the reason for medication nonadherence, and (4) treatment of choice. When the approach toward treatment of patients who were diagnosed with COVID-19 and had started treatment by a physician was evaluated, it was revealed that the nonadherence state emerged as a cycle. In the initial period, nonadherence due to the medication itself was observed. The second period is when the patients recognize their disease and collect information from their environment. Although this period begins before the disease, the search for informative sources intensifies, especially once the diagnosis has been received. In the third period, with their diagnosis and the information they had obtained, patients consider the reasons to use the medication and then decide whether or not to use it. In the fourth period, the patients who will not use antivirals consider other medications, such as anti-flu, anticoagulant, supplements, and nutrition.

Conclusion:

Since a specific treatment protocol has not yet been revealed for COVID-19, a new conceptual framework is required. In the current condition, the state of “hesitation for medical advice” arises for non-hospitalized patients.

Keywords

COVID-19 pandemicdischarge against medical advicehesitancy of medical advicemedication nonadherence
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 3 , June 2022 , pp. 1141 - 1151
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

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