Table 1 Themes and sub-themes identified in the analysis
Theme | Sub-theme | Mentioned by |
|---|---|---|
The effects and side effects of the depot-formulation | Withdrawal symptoms during induction period | Most patients |
Other side effects during induction period | Some patients | |
Lasting withdrawal symptoms and drug cravings | Patients who had discontinued depot injections | |
Lumps at injection sites | Many patients, but mentioned as big problem by some who had discontinued depot injections | |
Social and practical factors | Freedom of not having to attend the clinic as frequently | Many patients, patients with employment |
More time for family and leisure activities | Many patients | |
Benefit not having to handle medication | Patient who accepted depot injections | |
No social pressure to divert | Patient who accepted depot injections | |
Frequent clinic visits a routine that gives structure to everyday life | Patients who declined depot injections | |
Frequent clinic visits a valued social activity | Some patients | |
No practical benefits of depot injections | Some patients who collected their medication at pharmacies | |
Psychological benefits | A shift in self-perception – feeling more “free” and “normal” | Patient who accepted depot injections |
A relief not having to think about the medication every day | Patient who accepted depot injections | |
Reduced drug stigma | Patient who accepted depot injections | |
The clinic as a risk environment – reduced exposure to patients in active drug use | Patient who accepted depot injections | |
Psychological disadvantages | Unwillingness and/or fear to change an effective medication | Patients who declined depot injections |
Perceived need to take medication every day | Patients who declined depot injections | |
Depot injections perceived as untested with unknown side-effects | Patients who declined depot injections | |
Pharmaceutical atmosphere | Depot injections were introduced responsibly by staff | Most patients |
Trustful relationships with staff important when deciding on medication | Many patients | |
Information and rumors among patients may influence perceptions of depot injections | Many patients | |
Coercion leads to dissatisfaction, mistrust and negative rumors | Patients at one clinic |