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The myth of the medicine cabinet

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Professor Kerry Chamberlain from the School of Psychology at Massey University’s Albany campus says the three year HRC funded study began with several focus groups where people talked about medications. They then recruited a study group of 60 households.

“Once medicines disappear inside households we have very little idea of what goes on with them and how people use them. We know quite a lot about non-adherence and we know that about half of medications are not taken as directed,” he says.

Professor Chamberlain says they decided not to create a definition of what a medicine is, given the range of supplements and nutriceuticals used, and instead let people talk about anything they regard as functional for health-related purposes.

They visited the households and asked the occupants to talk broadly about how they view medications. They then got them to draw a house plan showing where they are kept and asked them to get all the medications and talk about them to establish who it was for, how did it get in the house, who controls it, and who uses it.

“Having the object in front of them actually produces a whole lot of telling about medicines that we would not otherwise get.”

They also asked them to undertake either a photographic or written diary recording what they see about medications over a one or two week period, what they take and how they feel about it.

Professor Chamberlain says they have only just begun their analysis but it is clear that people are experimenting all the time with medications. “They’re taking them as prescribed but modifying and changing them, worrying about taking a little more or a little less and so on. They are also taking over-the counter and alternative medications alongside these. So there is quite a lot of variability and changeability. It relates to the meanings that medications hold and the uses that people consider appropriate for them.”

It is also clear that the medicine cabinet is a thing of the past.

“Drugs are distributed all over the house according to their useage. Things that are taken regularly typically end up in the kitchen, or if they are taken privately, they end up in the bedroom,” says Professor Chamberlain.

“Things that are from the past will be buried in the bottom drawer of the bathroom or the top cupboard of the pantry or in a back cupboard in a back room. So there is a logic to the placement of medications within houses.”

The research team has also examined medication controversies to see how medicines were shown and debated in the media.

They focused on the Herceptin debate and the thyroid disorder drug Eltroxin which attracted complaints about side-effects when the drug company changed the country of manufacture.

Although some put it down to social contagion caused by media coverage, Professor Chamberlain says it also appears that media involvement effectively changed the channels of reporting and this led to many more people expressing their symptoms.

“We think that the symptoms around changing drugs and the side-effects of drugs and so-on are largely underreported and often dismissed by GPs."

Caption: Alcohol, alternative medicines and prescription drugs are often stored in the same place in homes