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Can patients' preferences for involvement in decision-making regarding the use of medicines be predicted?
S Garfield1, F Smith, S A Francis
1The School of Pharmacy, University of London, London, UK. sara.garfield@pharmacy.ac.uk
Objective:
The current study aimed to develop a model of patients' preferences for involvement in decision-making concerning the use of medicines for chronic conditions in the UK and test it in a large representative sample of patients with one of two clinical conditions.
Methods:
Following a structured literature review, an instrument was developed which measured the variables that had been identified as predictors of patients' preferences for involvement in decision making in previous research. Five hundred and sixteen patients with rheumatoid arthritis or type 2 diabetes were recruited from outpatient and primary care clinics and asked to complete the instrument.
Results:
Multivariate analysis revealed that age, social class and clinical condition were associated with preferences for involvement in decision-making concerning the use of medicines for chronic illness but gender, ethnic group, concerns about medicines, beliefs about necessity of medicines, health status, quality of life and time since diagnosis were not. In total, the fitted model explained only 14% of the variance.
Conclusion:
This study has demonstrated that current research does not provide a basis for predicting patients' preferences for involvement in decision-making.
Practice Implications:
Building concordant relationships may depend on practitioners developing strategies to establish individuals' preferences for involvement in decision-making as part of the ongoing prescriber-patient relationship.
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