ORIGINAL ARTICLE Exploring motivation and confidence in taking prescribed medicines in coexisting diseases: a qualitative study Allison Williams and Elizabeth Manias Aims and objectives. To explore the motivation and confidence of people with coexisting diabetes, chronic kidney disease (CKD) and hypertension to take their medicines as prescribed. Background. These comorbidities are major contributors to disease burden globally. Self-management of individuals with these coexisting diseases is much more complicated than that of those with single diseases and is critical for improved health outcomes. Design. Motivational interviewing telephone calls were made with participants with coexisting diabetes, CKD and hyper- tension. Methods. Patients aged  18 years with diabetes, CKD and systolic hypertension were recruited from outpatient clinics of an Australian metropolitan hospital between 2008–2009. An average of four motivational interviewing telephone calls was made with participants (n = 39) in the intervention arm of a randomised controlled trial. Data were thematically analysed using the modified Health Belief Model as a framework. Results. Participants’ motivation and confidence in taking prescribed medicines was thwarted by complex medicine regimens and medical conditions. Participants wanted control over their health and developed various strategies to confront threats to health. The perceived barriers of taking recommended health action outweighed the benefits of taking medicines as pre- scribed and were primarily related to copious amounts of medicines. Conclusion. Taking multiple prescribed medicines in coexisting diabetes, CKD and hypertension is a perpetual vocation with major psychosocial effects. Participants were overwhelmed by the number of medicines that they were required to take. The quest for personal control of health, fear of the future and the role of stress and gender in chronic disease management have been highlighted. Participants require supportive emotional interventions to self-manage their multiple medicines on a daily basis. Relevance to clinical practice. Reducing the complexity of medicine regimens in coexisting diseases is paramount. Individua- lised psychosocial approaches that address the emotional needs of patients with regular follow-up and feedback are neces- sary for optimal chronic disease self-management. Key words: comorbidities, diabetes, emotional support, hypertension, kidney disease, medication adherence, motivational interviewing, self-management Accepted for publication: 31 October 2012 Introduction The comorbidities of diabetes, chronic kidney disease (CKD) and cardiovascular diseases, specifically hyperten- sion, are increasing in prevalence as population ages (Sowers et al. 2001, Tong & Stevenson 2007). Self-man- agement of these coexisting diseases is much more complicated than that of single diseases, and appropriate self-management is critical for improved health outcomes (Bakris 2004). Authors: Allison Williams, PhD, Associate Professor, School of Nursing and Midwifery, Monash University Health Sciences, Frankston, Vic.; Elizabeth Manias, PhD, Professor, School of Health Sciences, The University of Melbourne, Carlton, Vic., Aus- tralia Correspondence: Allison Williams, Associate Professor/Campus Head, School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, PO Box 527, Frankston, Vic. 3199, Australia. Telephone: +61 3 9904 4377. E-mail: allison.williams@monash.edu © 2013 John Wiley & Sons Ltd Journal of Clinical Nursing, doi: 10.1111/jocn.12171 1