Physician patient relationship and medication compliance teaching

physician patient relationship and medication compliance teaching

Aug 1, We conducted a waiting room survey of patients consulting 22 Physician- Patient Relationship and Medication Compliance: A Primary Care Investigation . Effective professional intraoral tooth brushing instruction using the. May 16, Primary medication adherence occurs when a patient properly fills the A trusting patient–provider relationship, shared decision-making . High school graduate or General Educational Development (GED) certificate, 4 (15). Jul 22, Trust in the physician-patient relationship is crucial for medication adherence. Learn how you can build trust and improve the quality of care.

Physician-patient relationship and medication compliance: a primary care investigation.

Focus group context Throughout the focus groups, patients expressed anger, frustration and mistrust of their providers and the healthcare system. Receiving a hypertension diagnosis and an antihypertensive prescription Many patients were angry about and suspicious of their hypertension diagnosis. This and similar sentiments suggested that patients did not accept the diagnosis. Although anger was common, most patients indicated that receiving a prescription for an antihypertensive was not a surprise, citing family history or changes in their own health.

Patients wondered what might happen if they stopped taking the medication: Or is that going to be leveled off? Despite this, most patients held negative opinions of more affordable generic medications, believing they were less effective. Fears about medication side effects were nearly as common. Some patients expressed concern that taking an antihypertensive could cause another health problem that the provider might fail to disclose.

If the new antihypertensive was the first antihypertensive ever prescribed, patients described pill burden related to their other chronic medications as a rationale for not using the new drug. Other patients were convinced that the provider was getting a kickback from prescribing more medications. They want to make money.

Patients adopted a variety of strategies in place of taking an antihypertensive. Some opted for complementary medicines like red-yeast rice, even though this product is intended to lower cholesterol.

These alternatives were considered to have fewer side effects than prescription medications. A lot of prescription drugs are poison, actually. And they hurt a lot of the parts of your body.

physician patient relationship and medication compliance teaching

Preferences for shared decision making Patients discussed four attributes of the patient—provider conversation that might promote PMA to antihypertensive medications. Trust and respect were paramount. From the provider, patients expected an honest portrayal of the diagnosis and their treatment options: Patients were adamant that they wanted a full disclosure of side effects.

Patients equally wanted to hear about complementary medicines or lifestyle modifications that could be used in place of an antihypertensive.

Finally, patients wanted information about costs so that they would know whether they could afford the medication and were not embarrassed when they could not: So I talked to my doctor about this. And then why did you choose this one?

physician patient relationship and medication compliance teaching

Why do you think this will work better for me at this time? All wanted extensive information about side effects.

physician patient relationship and medication compliance teaching

Although patients agreed on content, they differed as to how that content should be presented. Some wanted a frequently asked questions list that described the benefits and risks of various antihypertensive medications. Still others wanted to track their blood pressure over time.

physician patient relationship and medication compliance teaching

Discussion We held four focus groups with 26 patients who failed to pick up a first prescription for a new antihypertensive medication. Measurement techniques for these aspects are given below.

Study instruments Part I of the survey instrument elicited health, demographic, and sociocultural information. Part II of the survey instrument assessed various aspects of the doctor—patient relationship, such as: The agreement between doctor and patient was assessed with the following questions: Results for all the six questions were then summed to give a cumulative score between 0 and 6, with higher scores indicating greater concordance.

In the present study those scoring 5 and 6 were taken as having complete agreement or concordance and the rest as partial concordance. Trust in physician Trust in the doctor was measured by the Trust in Physician Scale,[ 12 ] which yielded a score ranging from lowest to highest on the Likert Scale, with the higher scores indicating more trust.

In the present study, the highest two possible values were taken as complete trust in the physician and the rest of the scores were categorized as partial trust. Patient enablement This was measured by using the Enablement Index. This index, validated in primary care against patient satisfaction, asked whether the patients were more or less able to cope with life, understood and coped with their illness, and helped themselves as a result of the consultation with the physician.

The responses were scored from 1 to 4, with higher scores meaning more enablement.

Physician-patient relationship and medication compliance: a primary care investigation.

Here also, the highest two possible scores were taken as complete enablement, and the rest as partial enablement. Qualitative methods The following qualitative methods were used: Participant observation Besides interviewing the patients, the patients were also observed unobtrusively, while they interacted among themselves in the waiting rooms of the Outpatient Departments, or while standing in queue for registration.

Some were also observed during consultation with the doctor. Focus group discussion Twelve senior physicians, with at least 20 years experience in clinical practice, were approached to take part in a session of focus group discussion.

Out of these, 10 physicians agreed to participate in the focus group discussion on doctor—patient relationship. The senior investigator acted as a moderator during this focus group discussion and the second investigator took notes regarding the main themes that emerged during the discussion. Demographic profile A total of outdoor patients were surveyed. The mean age of the respondents was Out of the participants in the study, The majority of Physician patient concordance Out of the total respondents, Trust in physician This was less than the physician—patient agreement.

Out of the total of respondents, Patient enablement This measured the ability of the patient to cope with his illness after consultation with the doctor. In spite of a slightly low score on the overall trust in a physician, a larger proportion, Association of the sociocultural factors with physician—patient concordance This is shown in Table 1. Males tended to have a better concordance with their doctors Higher socioeconomic status was related to better concordance.

Urban residents had better concordance than rural residents. Surprisingly, those who believed in alternative medicine had more concordance than those who did not. People with higher education also showed better agreement with their doctors. Another surprising finding was that having the same mother tongue as the doctor, did not show better concordance.

Table 1 Open in a separate window Sociocultural factors and trust in physician This is shown in Table 2. Patients from the lower socioeconomic status had higher trust Urban residents had higher trust People who shared a common mother tongue with the doctor had a higher trust However, apart from gender, association with other determinants did not reach statistical significance [ Table 2 ].

Table 2 Open in a separate window Impact of sociocultural factors on patient enablement This is shown in Table 3. After consultations with the physician, the males were more enabled Patients from the lower socioeconomic group were more benefited from the doctor—patient interaction Other sociocultural factors were only marginally related to trust in the physician.

Table 3 Open in a separate window Whether good physician—Patient concordance leads to better trust in physician? The answer to this question is explored in Table 4. It will be seen from the Table that complete Physician Patient Concordance is associated with complete trust in the Physician. The association is strong ODDS ratio 5. Table 4 Open in a separate window Whether complete trust in the physician in turn leads to better patient enablement?