"I haven't even phoned my doctor yet." The advice giving role of the pharmacist during consultations for medication review with patients aged 80 or more: qualitative discourse analysis.
OBJECTIVE
To explore the advice giving role of pharmacists during consultation for medication review with patients aged 80 or more.


METHODS
Discourse analysis.


METHODS
Participants' homes.


METHODS
Subsample of consultations within a large randomised trial of home medication review among patients aged 80 or more who had been admitted to hospital.


METHODS
Extent to which advice given by pharmacists was accepted and acknowledged by patients.


RESULTS
Pharmacists found many opportunities to offer advice, information, and instruction. These advice giving modes were rarely initiated by the patients and were given despite a no problem response and deliberate displays of competence and knowledge by patients. Advice was often resisted or rejected and created interactional difficulties and awkward moments during the consultations.


CONCLUSIONS
The advice giving role of pharmacists during consultations with patients aged 80 or more has the potential to undermine and threaten the patients' assumed competence, integrity, and self governance. Caution is needed in assuming that commonsense interventions necessarily lead to health gain.
Salter
Charlotte
C
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ. c.salter@uea.ac.uk
Holland
Richard
R
Harvey
Ian
I
Henwood
Karen
K
D000368:Aged; D000369:Aged, 80 and over; D003157:Community Pharmacy Services / Q000592:standards*; D003376:Counseling; D005260:Female; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008297:Male; D010358:Patient Participation; D011369:Professional-Patient Relations; D012017:Referral and Consultation