Shared decision making and experiences of patients with long-term conditions: has anything changed?
Abstract Background Medication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision...
Main Authors: | , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2018-10-01
|
Series: | BMC Health Services Research |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12913-018-3575-y |
id |
doaj-aa0727c4c6274024b64fc1734f484d0e |
---|---|
record_format |
Article |
spelling |
doaj-aa0727c4c6274024b64fc1734f484d0e2020-11-25T02:00:26ZengBMCBMC Health Services Research1472-69632018-10-0118111010.1186/s12913-018-3575-yShared decision making and experiences of patients with long-term conditions: has anything changed?Reem Kayyali0Shereen Nabhani Gebara1Iman Hesso2Gill Funnell3Minal Naik4Thuy Mason5Mohammed Ahsan Uddin6Noor Al-Yaseri7Umar Khayyam8Teebah Al-Haddad9Roshan Siva10John Chang11School of Life Sciences, Pharmacy and Chemistry, Kingston University LondonSchool of Life Sciences, Pharmacy and Chemistry, Kingston University LondonSchool of Life Sciences, Pharmacy and Chemistry, Kingston University LondonSchool of Life Sciences, Pharmacy and Chemistry, Kingston University LondonSt. George’s HospitalSchool of Life Sciences, Pharmacy and Chemistry, Kingston University LondonSchool of Life Sciences, Pharmacy and Chemistry, Kingston University LondonSchool of Life Sciences, Pharmacy and Chemistry, Kingston University LondonSchool of Life Sciences, Pharmacy and Chemistry, Kingston University LondonSchool of Life Sciences, Pharmacy and Chemistry, Kingston University LondonCroydon Health Services NHS Trust, Croydon University HospitalCroydon Health Services NHS Trust, Croydon University HospitalAbstract Background Medication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision making (SDM), and the availability of rapid access clinics in primary care. This study aimed to investigate the experience of patients with LTCs about SDM including medication counselling and their awareness of community pharmacy medication review services. Methods A mixed research method with a purposive sampling strategy to recruit patients was used. The quantitative phase involved two surveys, each requiring a sample size of 319. The first was related to SDM experience and the second to medication counselling at discharge. Patients were recruited from medical wards at St. George’s and Croydon University Hospitals.The qualitative phase involved semi-structured interviews with 18 respiratory patients attending a community rapid access clinic. Interviews were audio-recorded and transcribed verbatim. Thematic analysis using inductive/deductive approaches was employed. Survey results were analysed using descriptive statistics. Results The response rate for surveys 1 and 2 survey was 79% (n = 357/450) and 68.5% (240/350) respectively. Survey 1 showed that although 70% of patients had changes made to their medications, only 40% were consulted about them and two-thirds (62.2%) wanted to be involved in SDM. In survey 2, 37.5% of patients thought that medication counselling could be improved. Most patients (88.8%) were interested in receiving the MUR service; however 83% were not aware of it. The majority (57.9%) were interested in receiving their discharge medications from community pharmacies. The interviews generated three themes; lack of patient-centered care and SDM, minimal medication counselling provided and lack of awareness about the MUR service. Conclusion Although patients wanted to take part in SDM, yet SDM and medication counselling are not optimally provided. Patients were interested in the MUR service; however there was lack of awareness and referral for this service. The results propose community pharmacy as a new care pathway for medication supply and counselling post discharge. This promotes a change of health policy whereby community-based services are used to enhance the performance of acute hospitals.http://link.springer.com/article/10.1186/s12913-018-3575-yChronic obstructive pulmonary disease/COPDShared decision making/SDMHealthcare professionals/HCPsPatient centered careHospital dischargeMedicine optimization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Reem Kayyali Shereen Nabhani Gebara Iman Hesso Gill Funnell Minal Naik Thuy Mason Mohammed Ahsan Uddin Noor Al-Yaseri Umar Khayyam Teebah Al-Haddad Roshan Siva John Chang |
spellingShingle |
Reem Kayyali Shereen Nabhani Gebara Iman Hesso Gill Funnell Minal Naik Thuy Mason Mohammed Ahsan Uddin Noor Al-Yaseri Umar Khayyam Teebah Al-Haddad Roshan Siva John Chang Shared decision making and experiences of patients with long-term conditions: has anything changed? BMC Health Services Research Chronic obstructive pulmonary disease/COPD Shared decision making/SDM Healthcare professionals/HCPs Patient centered care Hospital discharge Medicine optimization |
author_facet |
Reem Kayyali Shereen Nabhani Gebara Iman Hesso Gill Funnell Minal Naik Thuy Mason Mohammed Ahsan Uddin Noor Al-Yaseri Umar Khayyam Teebah Al-Haddad Roshan Siva John Chang |
author_sort |
Reem Kayyali |
title |
Shared decision making and experiences of patients with long-term conditions: has anything changed? |
title_short |
Shared decision making and experiences of patients with long-term conditions: has anything changed? |
title_full |
Shared decision making and experiences of patients with long-term conditions: has anything changed? |
title_fullStr |
Shared decision making and experiences of patients with long-term conditions: has anything changed? |
title_full_unstemmed |
Shared decision making and experiences of patients with long-term conditions: has anything changed? |
title_sort |
shared decision making and experiences of patients with long-term conditions: has anything changed? |
publisher |
BMC |
series |
BMC Health Services Research |
issn |
1472-6963 |
publishDate |
2018-10-01 |
description |
Abstract Background Medication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision making (SDM), and the availability of rapid access clinics in primary care. This study aimed to investigate the experience of patients with LTCs about SDM including medication counselling and their awareness of community pharmacy medication review services. Methods A mixed research method with a purposive sampling strategy to recruit patients was used. The quantitative phase involved two surveys, each requiring a sample size of 319. The first was related to SDM experience and the second to medication counselling at discharge. Patients were recruited from medical wards at St. George’s and Croydon University Hospitals.The qualitative phase involved semi-structured interviews with 18 respiratory patients attending a community rapid access clinic. Interviews were audio-recorded and transcribed verbatim. Thematic analysis using inductive/deductive approaches was employed. Survey results were analysed using descriptive statistics. Results The response rate for surveys 1 and 2 survey was 79% (n = 357/450) and 68.5% (240/350) respectively. Survey 1 showed that although 70% of patients had changes made to their medications, only 40% were consulted about them and two-thirds (62.2%) wanted to be involved in SDM. In survey 2, 37.5% of patients thought that medication counselling could be improved. Most patients (88.8%) were interested in receiving the MUR service; however 83% were not aware of it. The majority (57.9%) were interested in receiving their discharge medications from community pharmacies. The interviews generated three themes; lack of patient-centered care and SDM, minimal medication counselling provided and lack of awareness about the MUR service. Conclusion Although patients wanted to take part in SDM, yet SDM and medication counselling are not optimally provided. Patients were interested in the MUR service; however there was lack of awareness and referral for this service. The results propose community pharmacy as a new care pathway for medication supply and counselling post discharge. This promotes a change of health policy whereby community-based services are used to enhance the performance of acute hospitals. |
topic |
Chronic obstructive pulmonary disease/COPD Shared decision making/SDM Healthcare professionals/HCPs Patient centered care Hospital discharge Medicine optimization |
url |
http://link.springer.com/article/10.1186/s12913-018-3575-y |
work_keys_str_mv |
AT reemkayyali shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT shereennabhanigebara shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT imanhesso shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT gillfunnell shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT minalnaik shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT thuymason shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT mohammedahsanuddin shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT nooralyaseri shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT umarkhayyam shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT teebahalhaddad shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT roshansiva shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged AT johnchang shareddecisionmakingandexperiencesofpatientswithlongtermconditionshasanythingchanged |
_version_ |
1724960616672657408 |