title: Decision-making during initiation of medication therapy.
abstract: BACKGROUND
  Individuals' frequent and consistent interaction with medications can serve as a unifying element to help coordinate individuals' health care services. Despite its potential to improve coordination of heath care, initiation of medication therapy from the perspective of individuals' experiences remains largely unexamined.
  
  
  OBJECTIVE
  The objectives for this study were to describe the viewpoints of consumers, physicians, pharmacists, and social workers regarding initiation of medication therapy in terms of: (1) activation and engagement, (2) information processing, and (3) economic factors.
  
  
  METHODS
  Data were collected via mailed survey methodology from random samples of 400 adults, 400 physicians, 400 pharmacists, and 400 social workers residing in Minnesota. Responses to open-ended questions were coded using content analysis and summarized with descriptive statistics.
  
  
  RESULTS
  The findings showed that consumer views of (1) activation and engagement, (2) information processing, and (3) economic factors differed from the views of physicians, pharmacists, and social workers. Consumers typically view initiation of medication therapy within the context of their overall lives. Physicians view it as a biomedical puzzle in which diagnosis, drug product selection, and risk assessment are main concerns. Pharmacists view it as a health care systems puzzle in which insurance coverage, cost, and risk management are main concerns. Social workers view it as a social systems puzzle in which access to care, cost, and social support are main concerns.
  
  
  CONCLUSIONS
  Initiation of medication therapy is a disjointed experience for many consumers. The best timing for providing information about prescription drugs to individuals depends largely on what kinds of thoughts and impressions they have about a new therapy at various stages of the medication use process. The findings from this study can be useful for (1) developing consumer-centered approaches for medication use and (2) coordinating health care through the integration of the medication experience using consumer viewpoints.
authors.affiliation: College of Pharmacy, University of Minnesota, 308 Harvard Street S.E., Minneapolis, MN 55455, USA. Electronic address: schom010@umn.edu.
authors.forename: Jon C
authors.initials: JC
authors.lastname: Schommer
authors.affiliation: Department of Pharmacy Practice, The Raabe College of Pharmacy, Ohio Northern University, Ada, OH 45810, USA.
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Worley
authors.affiliation: Department of Pharmaceutical, Biomedical and Administrative Sciences, College of Pharmacy and Health Sciences Drake University, 2507 University Avenue, Des Moines, IA 50311-4505, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Kjos
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003657:Decision Making; D004358:Drug Therapy / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D010361:Patients; D010595:Pharmacists; D010820:Physicians; D055553:Prescription Drugs / Q000191:economics; D011306:Prescription Fees; D012947:Social Work
chemical_list: D055553:Prescription Drugs
keywords: Medication experience