Exploring patient experiences with prescription medicines to identify unmet patient needs: implications for research and practice.
BACKGROUND
Pharmacy services are offered to patients, and often, they decline participation. Research is needed to better understand patients' unmet needs when taking prescribed medications.


OBJECTIVE
To identify and characterize patients' unmet needs related to using prescribed medication for chronic conditions.


METHODS
Focus groups of patients using prescription medication for chronic conditions discussed their experiences with medications, starting from initial diagnosis to ongoing management. Sessions involved 40 patients from 1 Midwestern U.S. state. Major themes were identified using content analysis.


RESULTS
Three major themes emerged. First, patients seek information to understand their health condition and treatment rationale. Patients form an illness perception (its consequence, controllability, cause, and duration) that dictates their actions. Second, patients desire to be involved in treatment decisions, and they often feel that decisions are made for them without their understanding of the risk-to-benefit trade-off. Third, patients monitor the impact of treatment decisions to determine if anticipated outcomes are achieved.


CONCLUSIONS
The results were consistent with Dowell's therapeutic alliance model (TAM) and Leventhal's common sense model (CSM). The TAM can be used to model the consultative services between pharmacists and patients. The impact of the new services (or interventions) can be evaluated using the CSM. Patients expressed a strong desire to be involved in their treatment decisions. The effectiveness of medication therapy management services may be enhanced if pharmacists build on patients' desire to be involved in their treatment decisions and assist them to understand the role of medications and their risks and expected outcomes within the context of the patients' perceptions of illness and desired coping strategies.
The University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI 48109, USA. skucukar@umich.edu
Suzan N
SN
Kucukarslan
Nancy J W
NJ
Lewis
Leslie A
LA
Shimp
Caroline A
CA
Gaither
Daniel C
DC
Lane
Andrea L
AL
Baumer
D000223:Adaptation, Psychological; D000368:Aged; D002908:Chronic Disease; D003157:Community Pharmacy Services; D032882:Comprehension; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D057226:Information Seeking Behavior; D008297:Male; D055118:Medication Adherence; D008824:Michigan; D008875:Middle Aged; D020380:Needs Assessment; D010358:Patient Participation; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010465:Perception; D055553:Prescription Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D011369:Professional-Patient Relations; D018570:Risk Assessment; D016896:Treatment Outcome
D055553:Prescription Drugs