Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations

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Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations. / Weiss, Marjorie C; Platt, Jo; Riley, Ruth; Chewning, Betty; Taylor, Gordon; Horrocks, Susan; Taylor, Andrea.

In: Primary Health Care Research & Development, Vol. 16, No. 5, 09.2015, p. 513-27.

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Weiss, Marjorie C ; Platt, Jo ; Riley, Ruth ; Chewning, Betty ; Taylor, Gordon ; Horrocks, Susan ; Taylor, Andrea. / Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations. In: Primary Health Care Research & Development. 2015 ; Vol. 16, No. 5. pp. 513-27.

Bibtex

@article{0cdfd76de6ea4018a0be5995cfca740b,
title = "Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations",
abstract = "UNLABELLED: 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 United Kingdom, 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 A total of 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 (χ 2=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.",
keywords = "Adult, Drug Prescriptions, Female, General Practice, Humans, Male, Middle Aged, Nurse Practitioners, Patient Compliance, Patient Participation, Patient Satisfaction, Pharmacists, Referral and Consultation, United Kingdom, Journal Article, Research Support, Non-U.S. Gov't",
author = "Weiss, {Marjorie C} and Jo Platt and Ruth Riley and Betty Chewning and Gordon Taylor and Susan Horrocks and Andrea Taylor",
year = "2015",
month = sep,
doi = "10.1017/S146342361400053X",
language = "English",
volume = "16",
pages = "513--27",
journal = "Primary Health Care Research & Development",
issn = "1463-4236",
publisher = "Cambridge University Press",
number = "5",

}

RIS

TY - JOUR

T1 - Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations

AU - Weiss, Marjorie C

AU - Platt, Jo

AU - Riley, Ruth

AU - Chewning, Betty

AU - Taylor, Gordon

AU - Horrocks, Susan

AU - Taylor, Andrea

PY - 2015/9

Y1 - 2015/9

N2 - UNLABELLED: 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 United Kingdom, 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 A total of 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 (χ 2=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.

AB - UNLABELLED: 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 United Kingdom, 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 A total of 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 (χ 2=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.

KW - Adult

KW - Drug Prescriptions

KW - Female

KW - General Practice

KW - Humans

KW - Male

KW - Middle Aged

KW - Nurse Practitioners

KW - Patient Compliance

KW - Patient Participation

KW - Patient Satisfaction

KW - Pharmacists

KW - Referral and Consultation

KW - United Kingdom

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1017/S146342361400053X

DO - 10.1017/S146342361400053X

M3 - Article

C2 - 25482424

VL - 16

SP - 513

EP - 527

JO - Primary Health Care Research & Development

JF - Primary Health Care Research & Development

SN - 1463-4236

IS - 5

ER -