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Participation in decision making when starting long-term medication: patients´ experiences
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-4064-3815
Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. (eHälsoinstitutet ; eHealth Institute)ORCID iD: 0000-0002-4295-7201
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2014 (English)In: European Journal for Person Centered Healthcare, ISSN 2052-5648, E-ISSN 2052-5656, Vol. 2, no 3, p. 282-289Article in journal (Refereed) Published
Abstract [en]

Rationale, aim and objective

To achieve the beneficial effect of drug treatment and reduce unnecessary health care costs, patients must be involved in shared decision making. The aim of this study was to describe patient experiences of participation in decision making when starting long-term medication.

Method

Nine patients at two health care centers were semi-structured interviewed about their experiences, beliefs and feelings about their participation in the decision to start long-term medication. Data was analyzed by a qualitative content method.

Results

Respondents stated that participating in decision making in drug treatment requires knowledge of the relevant area and requiring trusting the physician. The respondent’s responsibility and motivation facilitate adherence to drug treatment. 

Conclusion

Patients sought participation in the decision making of long-term medication and wished for adequate time needed for this dialogue. If they lacked sufficient knowledge, they wanted relevant and useful information from the physician. To experience trust in the physician through a good encounter increases the possibility for participation and enhancement of medication adherence. In order to participate in decision making, the patient needs the physician’s encouragement.

 

Place, publisher, year, edition, pages
2014. Vol. 2, no 3, p. 282-289
Keywords [en]
patient, participastion, decision-making, drug treatment, adherence
National Category
Social and Clinical Pharmacy
Research subject
Chemistry, Biochemistry
Identifiers
URN: urn:nbn:se:lnu:diva-30337OAI: oai:DiVA.org:lnu-30337DiVA, id: diva2:663396
Available from: 2013-11-11 Created: 2013-11-11 Last updated: 2018-01-11Bibliographically approved
In thesis
1. Patient characteristic, perceived health and drug prescription in primary care
Open this publication in new window or tab >>Patient characteristic, perceived health and drug prescription in primary care
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Individuella faktorer, skattad hälsa och läkemedelsförskrivning inom primärvård
Abstract [en]

Patients have increased demands for information and involvement in decision-making including drug selection.  At the same time, society needs to limit costs, e.g. for subsidized drugs, thus entailing a challenge to in particular primary care. The overall aim of this thesis was to describe different factors influencing drug prescription in primary care and perceived health.

In a register study, the actual costs of prescribed subsidized drugs at five health care centers (HCCs) in areas of varying socioeconomic status (SES) were compared to the assigned drug budget. It revealed that HCCs with many citizens in the catchment area with low SES showed a deficit at year’s end. HCCs in areas with citizens with a higher SES showed a surplus.

In another register study, the prescription of drugs at lower or higher price levels for the diagnoses of chronic obstructive bronchitis, depression, diabetes and osteoporosis was studied. Drug prescription was then compared with individual factors for age, sex, education, income and country of birth, and whether the care provider was private or public. It was found that certain individual and provider factors appear to influence the prescribing of drugs of different price levels.

To investigate patient involvement in the decision to start long-term drug treatment, respondents who had recently begun taking medication were interviewed. The study showed that patient participation was important, but that participation implied different things to different patients. One view was that participation could be achieved without sharing the decision-making process, whereas another view was that participation was more or less willingness to become involved in decision-making. Prerequisites for patient participation were knowledge in the relevant area and trust in the physician.

A fourth study examined how individuals aged 65-80 years rated their health. The study showed that health was assessed much lower in respondents with depressive symptoms compared to those without corresponding symptoms. Health was also assessed as worse for people with hypertension and in those treated with drugs for depression and hypertension. Health was perceived as better in the younger age groups, in individuals with higher educational levels, and for men. 

Drug prescription in primary care is controlled, in addition to medical necessity, by economic constraints, and that patients need an opportunity to influence decisions about their care and treatment. However, economic constraints make it difficult for physicians to support patients in their choice of medication. This may influence patient adherence to medication.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2013. p. 72
Series
Linnaeus University Dissertations ; 136/2012
National Category
Nursing
Research subject
Natural Science, Biomedical Sciences
Identifiers
urn:nbn:se:lnu:diva-25640 (URN)978-91-87427-29-9 (ISBN)
Public defence
2013-05-29, N2007 Västergård, Smålandsgatan 26a, Kalmar, 09:43 (Swedish)
Opponent
Supervisors
Available from: 2013-05-23 Created: 2013-05-14 Last updated: 2017-05-30Bibliographically approved

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Semark, BirgittaPetersson, GöranNilsson, Gunilla

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