Background

The support that health care professionals offer to patients in relation to them getting the best out of their medicines is crucial^1,2. Yet, while the majority of studies focus on professionally defined needs of patients and carers in this area, few qualitative studies have considered how patients view the support given to them by various members of the primary health care team. The current policy agenda identifies the importance of gaining the consumers' perspective on service delivery and treatment, by actively encouraging patient participation and teamwork³. This should not only lead to better treatment outcomes but also to improvements in service provision. How older patients regarded their care and their understanding of the roles various health professionals played, in medicines management, was the focus of the present research.

Objective

To explore the older persons' perception of the medicines support given by health care professionals.

Study Design

A qualitative study based on semi-structured interviews of older patients, their carers, community pharmacists, practice nurses and general practitioners (Total no=75). The interviews, carried out as part of a wider PhD on the practice nurses' role in medicines management, were arranged with health professionals and patients from 15 practices in Leeds. Detailed examination of the transcripts continued throughout the collection process. Issues unearthed during early interviews were explored in subsequent ones. Data collection continued until no further issues were identified.

Results

Preliminary analysis of the interviews identified a number of key themes. These concerned prevalent notions held by older people about medicines and the support they received from a variety of healthcare professionals. Older patients expressed satisfaction with the services they received, citing the GP as the 'expert' in medicines, together with some ambivalence towards the medicines themselves. Pharmacists and nurses were also used to 'sound out advice' and legitimate their concerns before they were presented to the GP. Conversely, from the professional perspective, older patients were perceived to be forgetful, verbally compliant and passive during consultation, even when it was known by experience that the patient had a history of non-compliance.

Discussions

These notions have some relevance to the type of support that was sought by the older patient and given by the professional. It is important for healthcare professionals to unearth and redress conflicting ideas about medication. They also need to be aware of the way they are regarded by patients and work toward equal therapeutic partnerships to promote better medicines use.

References

1. Department of Health. (2000). National Service Framework for older people. London; HMSO London
2. National Pharmaceutical Association. (1998) Medication management: everybody's problem. NPA, St Albans
3. Royal Pharmaceutical Society of Great Britain & British Medical Association. (2000) Team-working in primary healthcare: realising shared aims in patient care. RSPGB & BMA London