Attitudes toward concordance and self-efficacy in decision making: a cross-sectional study on pharmacist–patient consultations

Abstract

PurposeThis study investigated patients’ and pharmacists’ attitudes toward concordance in a pharmacist–patient consultation and how patients’ attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use.Subjects and methodsA cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent t-test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients’ self-efficacy in decision making.ResultsA total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; p<0.001). Patients had an average score of 76.7% (SD=14.73%) on the Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients’ perceived level of involvement, and attitudes toward concordance are significant predictors of patients’ self-efficacy in decision making (p<0.05).ConclusionPatients who felt involved in their consultations had more positive attitudes toward concordance and higher confidence in making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients’ involvement in medication-related decision making.

Assessing Individual Medication Adherence among Chronic Kidney Disease Patients: A Multi-centered Study

“…Other significant barriers to insulin omission reported were injection site reactions, injections being time-consuming, intrusion with physical activity and lack of adequate injection instructions [28]. A few approaches to overcome these barriers include involving patients in the decision-making process that may aid in providing the best individualized treatment plan [29,30]. Intervention and education by a pharmacist was also likely to improve adherence to medication whilst improving clinical outcome [31].…”

A multi-stakeholder approach to the co-production of the research agenda for medicines optimisation

“…The PPI research infrastructure has existed for over a decade [38] and the importance of PPI in this prioritisation exercise was reinforced by the many differences between their views and those of the non-PPI participants [39]. Given that patient involvement in healthcare decision-making can lead to better affective, cognitive and health outcomes [40,41], the value of involving patients in the entire research process is implicit in the top-ranked 'patient concerns', 'Is there a shared decision (with patients) about using each medicine? '.…”

Adesão À Farmacoterapia, Que Universo É Esse? Uma Revisão Narrativa

“…Os modelos com abordagem interprofissional nas tomadas de decisões compartilhadas permitem a melhora na qualidade do apoio à decisão e valorizam o cuidado centrado no paciente 39 . No contexto da adesão à farmacoterapia, por exemplo, os farmacêuticos estão em posição estratégica para se comunicarem com as pessoas-pacientes sobre os seus medicamentos e encorajá-los no envolvimento de decisões voltadas às suas necessidades principais, por meio da decisão compartilhada e apoio às necessidades individuais 40,41 . Dessa forma, estudos mais aprofundados sobre intervenções de farmacêuticos no apoio e incentivo ao envolvimento das pessoas-pacientes na tomada de decisões relacionadas à medicação são recomendados 41 .…”

“…No contexto da adesão à farmacoterapia, por exemplo, os farmacêuticos estão em posição estratégica para se comunicarem com as pessoas-pacientes sobre os seus medicamentos e encorajá-los no envolvimento de decisões voltadas às suas necessidades principais, por meio da decisão compartilhada e apoio às necessidades individuais 40,41 . Dessa forma, estudos mais aprofundados sobre intervenções de farmacêuticos no apoio e incentivo ao envolvimento das pessoas-pacientes na tomada de decisões relacionadas à medicação são recomendados 41 . O dicionário médico de Stedman's Online 42 define compliance como "a não contradição", a aceitação e a congruência de comportamento com que uma pessoa segue o regime terapêutico prescrito por um médico ou por outro profissional de saúde.…”