BACKGROUND: Managing multiple chronic conditions often requires people to make treatment decisions, particularly when faced with competing demands. This usually leads to condition prioritisation, where one condition is prioritised over the other. Considering that diabetes and hypertension are closely linked, prioritising medication for one condition over the other can have serious health implications. This study aimed to explore condition prioritisation in people with coexisting diabetes and hypertension, and its impact on medication adherence. METHODS: A qualitative study was conducted with adults on medications to manage coexisting diabetes and hypertension, residing in Australia. Thirty participants were asked to indicate the condition they considered more important to manage and discuss their prioritisation. Thematic analysis was used to identify key factors influencing condition prioritisation. The Adherence to Refills and Medication Scale questionnaire was used to assess medication adherence for each condition. RESULTS: Medication adherence scores varied in most cases, with diabetes and hypertension scores ranging from 12 to 21 and 12 to 26, respectively. Participants who prioritised one condition over the other demonstrated better medication adherence for the condition they perceived as more important. The key themes influencing disease prioritisation emerged primarily as patient-related and condition-related factors. Most participants prioritised diabetes due to its immediate perceived risks, fear of complications and previous experience with the condition. CONCLUSION: Participants' perceptions of a condition and observed effects of the condition influenced condition prioritisation. This in turn influenced medication adherence, as participants were more vigilant in managing the condition they prioritised. These findings emphasise the need for tailored interventions that address the challenges of managing multiple conditions and medications. PATIENT OR PUBLIC CONTRIBUTION: People living with diabetes and hypertension took part as study participants but were not involved in the design, analysis, or dissemination stages of this research. A lay summary of the results will be shared via email with participants who expressed interest in receiving the findings of the study.
Maniki et al. (Mon,) studied this question.