Appropriation of a therapeutic innovation in a context of chronic disease: individual and organizational issues

Abstract

Given the importance of medical innovation in the care of patients and considering the potential difficulties of treatments acceptance by individuals, this article aims to better understand the mechanisms of therapeutic innovation adoption by patients treated for a chronic disease. In this perspective, the theoretical framework of this research is articulated around the concepts of Service-Dominant Logic and appropriation developed in marketing. A qualitative study, carried out with 13 dialysis patients, demonstrates that interviewees do not appropriate a medicine but more widely a care service which is co-created. Furthermore the analysis of the appropriation process reveals the role of certain “facilitators” (such as guides, rites), the influence of trust which alters the phases of exploration and marking, and the importance of the nidification phase. This appropriation of care service reveals some applications in terms of autonomy and
compliance of patients, and health care organization at the territorial level.