Shared decision making, satisfaction with care and medication adherence among patients with diabetes

Milky, Gediwon; Thomas, Joseph

doi:10.1016/j.pec.2019.10.008

Cited by 62 publications

(49 citation statements)

References 51 publications

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“…Shared decision-making aims at a joint decision between the doctor and the patient (e.g., about a therapy) and is considered a gold standard of doctor-patient communication (Elwyn et al 2012). In fact, patients want to be involved in medical decisions that affect them and are more satisfied when they are involved in these decisions (Altin and Stock 2016;Milky and Thomas 2020). Our survey showed that patients felt more activated and better supported during a guide-based conversation.…”

Section: Discussionmentioning

confidence: 93%

“…Non-adherence, on the other hand, was associated with frequent visits to the doctor and longer treatment times, in addition to a decrease in the effectiveness of treatments and more frequent hospitalizations (Simpson et al 2006;Howard et al 2007;Cramer et al 2007). Recall of drug information correlates with patient participation and patients like to be involved (Dillon 2012;Altin and Stock 2016;Milky and Thomas 2020). Taken together, the prescription talk is a crucial part of physician-patient interaction that helps to ensure safe and effective drug therapy.…”

Section: Introductionmentioning

confidence: 99%

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Aspects of Medication and Patient participation—an Easy guideLine (AMPEL). A conversation guide increases patients’ and physicians’ satisfaction with prescription talks

Kirsch

Matthes

2021

Naunyn-Schmiedeberg's Arch Pharmacol

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Patients want more information and active participation in medical decisions. Information and active participation correlate with increased adherence. A conversation guide, combining patient-relevant drug information with steps of shared decision-making, was developed to support physicians in effective and efficient prescription talks. Six GP trainees in community-based primary care practices participated in a controlled pilot study in sequential pre-post design. Initially, they conducted 41 prescription talks as usual, i.e., without knowing the guide. Then, they conducted 23 talks considering the guide (post-intervention phase). Immediately after the respective talk, patients filled in a questionnaire on satisfaction with the information on medication and physician–patient interaction, and physicians about their satisfaction with the talk and the application of the guide. Patients felt better informed after guide-based prescription talks (e.g., SIMS-D in median 10 vs. 17, p < 0.05), more actively involved (KPF-A for patient activation 2.9 ± 0.8 vs. 3.6 ± 0.8, p < 0.05), and more satisfied with the physician–patient interaction. Physicians rated the guide helpful and feasible. Their satisfaction with the conversation was significantly enhanced during the post-intervention phase. The evaluation of the duration of the talk was not influenced. Enhanced patients’ and physicians’ satisfaction with prescription talks encourages further examinations of the conversation guide. We invite physicians to try our guide in everyday medical practice.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Aspects of Medication and Patient participation—an Easy guideLine (AMPEL). A conversation guide increases patients’ and physicians’ satisfaction with prescription talks

Kirsch

Matthes

2021

Naunyn-Schmiedeberg's Arch Pharmacol

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“…The prescription talks were videotaped and transcribed based on a predefined protocol using the software MAXQDA version 2018 for qualitative data analysis (VERBI Company Ltd. Berlin, Germany). We applied a content analysis according to Mayring on the anonymised transcripts (Mayring 2010). Categories were formulated deductively considering the conversation guide mentioned above (Hauser and Matthes 2017;Kirsch and Matthes 2021).…”

Section: Content Analysismentioning

confidence: 99%

“…Whenever interpretations of the code were divergent, a consensus was reached by discussing that particular text passage. As suggested by Mayring, we subjected the identified codes to an exploratory frequency analysis ('quantitative content analysis') to compare the prescription talks both with each other and each before and after the intervention (Mayring 2010). Regardless of how many subcategories were addressed or how often a main category was touched during a talk, it was counted only once.…”

Section: Content Analysismentioning

confidence: 99%

“…For safe prescription, it is also important to involve patients in the medical process. Not only do patients like to be involved, their participation also correlates with the ability to recall the given information (Dillon 2012;Altin and Stock 2016;Milky and Thomas 2020). In practice, however, decisions are often made by the physicians alone (Loh et al 2007;Karnieli-Miller and Eisikovits 2009).…”

Section: Introductionmentioning

confidence: 99%

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A simulation-based module in pharmacology education reveals and addresses medical students’ deficits in leading prescription talks

Kirsch

Matthes

2021

Naunyn-Schmiedeberg's Arch Pharmacol

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Although doctor-patient communication is essential for drug prescription, the literature reveals deficits in this area. An educational approach at the Cologne medical faculty aims at identifying and addressing those deficits in medical students.Fifth-year medical students first conducted a simulated prescription talk spontaneously. Subsequently, the conversation was discussed with peer students. A pharmacist moderated the discussion based upon a previously developed conversation guide. Afterwards, the same student had the conversation again, but as if for the first time. Conversations were video-recorded, transcribed and subjected to quantitative content analysis. Four days after the simulation, the students who conducted the talk, those who observed and discussed it, and students who did neither, completed a written test that focused on the content of an effective prescription talk.Content analysis revealed clear deficits in spontaneously led prescription talks. Even essential information as on adverse drug reactions were often lacking. Prescription talks became clearly more informative and comprehensive after the short, guided peer discussion. With regard to a comprehensive, informative prescription talk, the written test showed that both the students who conducted the talk and those who only observed it performed clearly better than the students who did not participate in the educational approach.Deficits regarding prescription talks are present in 5th year medical students. We provide an approach to both identify and address these deficits. It thus may be an example for training medical students in simulated and clinical environments like the EACPT recommended to improve pharmacology education.

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Supplemental Nutrition Assistance Program and Adherence to Antihypertensive Medications

Islam,

Oyarzun-Gonzalez,

Bose-Brill

et al. 2024

JAMA Netw Open

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ImportanceNonadherence to antihypertensive medications is associated with uncontrolled blood pressure, higher mortality rates, and increased health care costs, and food insecurity is one of the modifiable medication nonadherence risk factors. The Supplemental Nutrition Assistance Program (SNAP), a social intervention program for addressing food insecurity, may help improve adherence to antihypertensive medications.ObjectiveTo evaluate whether receipt of SNAP benefits can modify the consequences of food insecurity on nonadherence to antihypertensive medications.Design, Setting, and ParticipantsA retrospective cohort study design was used to assemble a cohort of antihypertensive medication users from the linked Medical Expenditure Panel Survey (MEPS)–National Health Interview Survey (NHIS) dataset for 2016 to 2017. The MEPS is a national longitudinal survey on verified self-reported prescribed medication use and health care access measures, and the NHIS is an annual cross-sectional survey of US households that collects comprehensive health information, health behavior, and sociodemographic data, including receipt of SNAP benefits. Receipt of SNAP benefits in the past 12 months and food insecurity status in the past 30 days were assessed through standard questionnaires during the study period. Data analysis was performed from March to December 2021.ExposureStatus of SNAP benefit receipt.Main Outcomes and MeasuresThe main outcome, nonadherence to antihypertensive medication refill adherence (MRA), was defined using the MEPS data as the total days’ supply divided by 365 days for each antihypertensive medication class. Patients were considered nonadherent if their overall MRA was less than 80%. Food insecurity status in the 30 days prior to the survey was modeled as the effect modifier. Inverse probability of treatment (IPT) weighting was used to control for measured confounding effects of baseline covariates. A probit model was used, weighted by the product of the computed IPT weights and MEPS weights, to estimate the population average treatment effects (PATEs) of SNAP benefit receipt on nonadherence. A stratified analysis approach was used to assess for potential effect modification by food insecurity status.ResultsThis analysis involved 6692 antihypertensive medication users, of whom 1203 (12.8%) reported receiving SNAP benefits and 1338 (14.8%) were considered as food insecure. The mean (SD) age was 63.0 (13.3) years; 3632 (51.3%) of the participants were women and 3060 (45.7%) were men. Although SNAP was not associated with nonadherence to antihypertensive medications in the overall population, it was associated with a 13.6–percentage point reduction in nonadherence (PATE, −13.6 [95% CI, −25.0 to −2.3]) among the food-insecure subgroup but not among their food-secure counterparts.Conclusions and RelevanceThis analysis of a national observational dataset suggests that patients with hypertension who receive SNAP benefits may be less likely to become nonadherent to antihypertensive medication, especially if they are experiencing food insecurity. Further examination of the role of SNAP as a potential intervention for preventing nonadherence to antihypertensive medications through prospectively designed interventional studies or natural experiment study designs is needed.

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Shared decision making, satisfaction with care and medication adherence among patients with diabetes

Cited by 62 publications

References 51 publications

Aspects of Medication and Patient participation—an Easy guideLine (AMPEL). A conversation guide increases patients’ and physicians’ satisfaction with prescription talks

Aspects of Medication and Patient participation—an Easy guideLine (AMPEL). A conversation guide increases patients’ and physicians’ satisfaction with prescription talks

A simulation-based module in pharmacology education reveals and addresses medical students’ deficits in leading prescription talks

Supplemental Nutrition Assistance Program and Adherence to Antihypertensive Medications

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