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What Patients and Carers Want from Medication Review

In discussing medication review, patients and carers were remarkably clear about their needs.
 
People simply wished to tell their health professional how they felt, and to see if they were taking the best medicines for their problems. To do this, they felt that they needed:
  • Specific time set aside for medication review
    "It's no good just at the end of the surgery"
    "If there's a waiting room of people, I feel guilty and I can't talk"
  • Someone to listen carefully to questions
  • Clear explanations in simple language
  • An open interaction where they could be honest about what they were actually taking, and the health professional would be honest about the consequences of taking (or not taking) the medicines.
 
The list of things people would like to discuss in a review of their medicines ranged from fundamental:
"I'd like to know what's wrong with me"
to wide-ranging:
"I'd like to know what new medicines are available to prevent me from becoming ill."
Ideas and suggestions reflect a number of key topics.
 
1 General information about the medical condition and treatment
  • Confirmation of "what you are on and why"
  • What medication is for which condition
    "You get a lot of tablets, but no-one tells you what's what."
  • Likelihood of side effects actually happening to me
  • What to expect on a day-to-day basis
    "Will my pain go?"
 
2 How to take pills properly
  • What to take
  • How much to take
  • When to take it (time of day, with meals etc)
  • How long from starting the treatment until it takes effect
  • Advice on "pill pots" (ie monitored dosage systems).
 
3 Medication options
  • "Do I really need ALL these tablets?"
  • Has any new product come onto the market since the medicine was initially prescribed?
  • Information and reassurance about "postcode prescribing": is anything being withheld for financial reasons?
 
4 Personal beliefs and preferences
  • "I should make it clear that I might be willing to shorten my life if it improved my quality of life. Doctors should be honest. They should talk about what it would mean to me and how I live my life… If you are in so much pain that you cannot move it may not be apparent to the doctor in his little kingdom."
 
5 Concerns about medication
  • Is a particular symptom a side effect of my medicine? Which one?
  • Packaging issues
  • Changes of medication name and/or appearance of packaging
  • Can pills "build up in the system"?
 
One person summed it up as:
 
"We'd like to ask all the things we couldn't ask when we were very ill."
 
Many people we spoke to were concerned about how they would remember what they were told in their medication review. Memory was perceived as not always reliable, so there might be a need for a note of some kind as an aide memoire for what had been discussed in the review.

 
Next > Conclusions from Listening to Patients