Abstract

Patients want more information and active participation in medical decisions. Information and active participation correlate with increased adherence. A conversation guide, combining patient-relevant drug information with steps of shared decision-making, was developed to support physicians in effective and efficient prescription talks. Six GP trainees in community-based primary care practices participated in a controlled pilot study in sequential pre-post design. Initially, they conducted 41 prescription talks as usual, i.e., without knowing the guide. Then, they conducted 23 talks considering the guide (post-intervention phase). Immediately after the respective talk, patients filled in a questionnaire on satisfaction with the information on medication and physician–patient interaction, and physicians about their satisfaction with the talk and the application of the guide. Patients felt better informed after guide-based prescription talks (e.g., SIMS-D in median 10 vs. 17, p < 0.05), more actively involved (KPF-A for patient activation 2.9 ± 0.8 vs. 3.6 ± 0.8, p < 0.05), and more satisfied with the physician–patient interaction. Physicians rated the guide helpful and feasible. Their satisfaction with the conversation was significantly enhanced during the post-intervention phase. The evaluation of the duration of the talk was not influenced. Enhanced patients’ and physicians’ satisfaction with prescription talks encourages further examinations of the conversation guide. We invite physicians to try our guide in everyday medical practice.

Highlights

  • In most consultations, physicians prescribe a medication to their patients (Stevenson et al 2000)

  • We have developed a guide that combines patient-relevant drug information based on the Medication Communication Index (MCI) with the basic steps of shared decision-making (SDM) (Loh et al 2007; Tarn et al 2009a; Hauser and Matthes 2017)

  • The applicability and possible effect of a self-developed conversation guide for prescription talks was examined by means of questionnaires

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Summary

Introduction

Physicians prescribe a medication to their patients (Stevenson et al 2000). Physicians are one of the most important sources of drug information (Nink and Schröder 2005; Tarn et al 2009b). Patients want more information about their drug therapy, and often more than their physicians assume (Nair et al 2002; Twigg et al 2016). We have developed a guide that combines patient-relevant drug information based on the Medication Communication Index (MCI) with the basic steps of shared decision-making (SDM) (Loh et al 2007; Tarn et al 2009a; Hauser and Matthes 2017). The guide aims at a conversation in which patients receive satisfying information and are activated to participate in therapy decisions through a structured approach. Parts of this work have already been published as a conference abstract (Kirsch and Matthes 2021)

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