Chronic Condition Patients’ Preferences When Prescribed a New Medication
Patient Centered Outcomes Research Institute (PCORI)
10/15/2012 – 6/30/2014
“Patients can easily be overwhelmed, confused and many times don’t fully understand their need for new medications, or when the dosages are to be administered” (patient stakeholder/research partner quote). The long term goal is to refine medication science by developing patient-centered assessment, monitoring and management guidelines for patients and health professionals. The objective of this pilot study, Medication-taking Preferences & Practices of Patients with Chronic Conditions, is to advance knowledge about the medication-taking perspectives, experiences, and behaviors of older adults with chronic conditions to inform future research related to patient-centered medication prescribing, monitoring and management. Specifically, this pilot study addresses the following PCORI area of interest: “evaluating methods that can be used to assess the patient perspective when researching behaviors and choices within the patient’s control that may influence outcomes.” The rationale that underlies the pilot study is that medication-taking practices are wholly within the patients’ control, and are foundational to controlling risk factors, reducing complications, and improving outcomes for older adults with multiple chronic medical conditions. To meet the objective of this application, the following specific aims will be pursued: 1) identify perceptions and behaviors surrounding the medication-taking process of older adults with multiple chronic medical conditions; and 2) generate an interpretation of the meaning of medication-taking among older adults with multiple chronic medical conditions. To achieve these aims, data will be obtained in “real time” from patients that have received a new prescription; as thoughts about medicines occur, patients will audio record them using smart phone technology. The smart phones will include prompts to help patient participants record spontaneous thoughts about medication use throughout the day. An electronic diary will be gathered via smart phone technology for 1 month. Findings from electronic diaries will be logged, analyzed and qualitatively analyzed. In addition, some patients will provide in-depth hermeneutic (interpretive) interviews and these data will provide rich descriptions and interpretive commentary about the experience of receiving a new medication prescription, how it is experienced, and what happens in the process. The objective is to uncover previously unidentified areas of common experience in older persons with multiple chronic conditions who have received a new prescription. All intentions are for the participant to reveal storied, contextual accounts of experience as it reveals itself in conversation. Common experiences and patterns of influences, that are often surprising or unexpected, will be categorized and assessed. The expected outcomes of this pilot study are improved knowledge of medication-taking perceptions, experiences, and practices of older adults with multiple chronic medical conditions—knowledge that is critical to advance patient-centered medication science.