Communication patterns in home medication review for individuals with vision impairment: A qualitative study

Individuals with vision impairment face persistent barriers to medication self-management, yet how they navigate medication-related uncertainty with healthcare providers has received little direct examination. This study examined pharmacist-patient communication during home medication review to characterize the micro-level interactional dynamics of these consultations.

A qualitative study was conducted with 27 adults with vision impairment (13 total blindness, 14 low vision; mean age 67.9 years) receiving community-based home medication review services in metropolitan South Korea. Data comprised direct observation of consultations, audio-recorded transcripts, field notes, and multidisciplinary case meeting records, analyzed using conventional content analysis and reported following the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Analysis revealed four distinctive communication patterns: safety verification and authority dependence, in which participants sought binary decision recommendations rather than neutral information; symptom attribution and causal inquiry, characterized by systematic medication blaming linked to physical barriers in the home environment; anxiety expression centered on residual vision loss and polypharmacy fear as strategic bids for evaluative reassurance; and self-negotiation of medication regimens, ranging from risk-averse adjustment consistent with publicly available information to unverified beliefs stated as settled and identified as incorrect only on direct regimen review. Multidisciplinary case meetings identified structural coordination needs extending beyond pharmacist-patient dialogue.

In these consultations, professional dialogue supported verification and reassurance, while direct regimen review revealed unverified beliefs and gaps in medication knowledge. The findings suggest a role for accessible counseling that combines information provision with professional verification.

Providers should recognize that this population requires verification-oriented rather than information-oriented communication, including proactive screening for unverified beliefs, attention to vision-related anxiety as a filter in medication decisions, and coordination with social services for environmental needs.