Research

Medication Decision Making and Patient Outcomes in GP, Nurse and Pharmacist Prescriber Consultations


Reference:

Weiss, M., Platt, J., Riley, R., Chewning, B., Taylor, G., Horrocks, S. and Taylor, A., 2015. Medication Decision Making and Patient Outcomes in GP, Nurse and Pharmacist Prescriber Consultations. Primary Health Care Research & Development

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    Official URL:

    http://dx.doi.org/10.1017/S146342361400053X

    Abstract

    Aim: The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy. Background: There are a range of ways for defining and measuring the process of concordance, or shared decision-making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging. In the UK, nurses and pharmacists can now take on a prescribing role, engaging in shared decision-making. Given the different professional backgrounds of GPs, NPs and PPs, this study sought to explore the process of shared decision making across these three prescriber groups. Methods: Analysis of audio-recordings of consultations in primary care in South England between patients and GPs, NPs and PPs. Analysis of patient questionnaires completed post consultation. Findings: 532 consultations were audio-recorded with 20 GPs, 19 NPs and 12 PPs. Prescribing decisions occurred in 421 (79%). Patients were given treatment options in 21% (102/482) of decisions, the prescriber elicited the patient’s treatment preference in 18% (88/482) and the patient expressed a treatment preference in 24% (118/482) of decisions. PPs were more likely to ask for the patient’s preference about their treatment regimen (X2=6.6, p=0.036, Cramer’s V=0.12) than either NPs or GPs. Of the 275 patient questionnaires, 192(70%) could be matched with a prescribing decision. NP patients had higher satisfaction levels than patients of GPs or PPs. More time describing treatment options was associated with increased satisfaction, adherence and greater perceived practitioner empathy. While defining, measuring and enabling the process of shared decision making remains challenging, it may have patient benefit.

    Details

    Item Type Articles
    CreatorsWeiss, M., Platt, J., Riley, R., Chewning, B., Taylor, G., Horrocks, S. and Taylor, A.
    DOI10.1017/S146342361400053X
    Uncontrolled Keywordsprimary care,pharmacist,nurse,general practitioner,prescribing
    DepartmentsFaculty of Science > Pharmacy & Pharmacology
    Faculty of Humanities & Social Sciences > Health
    Research CentresEPSRC Centre for Doctoral Training in Statistical Mathematics (SAMBa)
    RefereedYes
    StatusPublished
    ID Code43636

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