Patient readiness: what do patients need to be partners? The best outcomes from recommended medicines are only achievable with significant input from the individual. To become able to provide this insight patients need to play a dynamic part in the discussion including engaging in distributed decision making, and patients also need understanding through the provision of information which is accessible and understandable. Although much attention has been paid in recent years to increasing health professionals’ consultation skills the same cannot be said for patients.
The options for information provision include spoken information, written information, and web‐structured information. Most spoken information provided during connections with health professionals is forgotten 14 and there is often little time designed for this in consultations. People also need to absorb information they are given and questions might only arise later.
Finally, the review demonstrated that people would like written information for just two reasons. First for preliminary decisions about whether to take a medication or not. Hence people would value information about the range of treatments available prior to the prescribing decision is manufactured. Second they need information for ongoing decisions about the management of medications and interpreting symptoms. This suggests the necessity for two types of written information.
Provision of usable information plays an integral role in giving patients confidence to take part in decisions about their medications. This can relate to very simple issues such as how to pronounce a medication name. This is commonly used in leaflets supplied in the US and Australia. It is highly empowering to permit patients to be confident in saying the name of their medicines correctly.
It is also important to tailor information (both spoken and written) relating to patients’ desires and needs. This can relate to the known level or degree to which patients want information. It can also relate with taking account of physical impairments notably visual impairment in older people, which may affect manipulation of written documents. Web‐structured information is potentially a robust tool in informing patients because of its availability before, after and during consultations. However allowing patients to find information that is reliable is an important task that medical researchers can assist with.
A main factor in effective information provision is making certain information from different sources including spoken, written, and internet is constant and does not give differing advice. One option to help accomplish that would be for medical researchers to use the mandated patient leaflet supplied with all medicines as the foundation for the information they provide to patients about the medicines they prescribe on their behalf. Particularly important to aid the process of partnership in medication taking is the provision of understandable and usable information about the probability of harm and benefit.
The appearance of the probability of side effects has been found to be ideal when natural frequencies are used, for example, ‘affects significantly less than one in 100 patients’24. However, the best way to provide advantage information is not yet known, particularly numerical benefit information. Ongoing research by one of the authors (DKR) has up to now shown that the use of a patient-friendly version of ‘numbers had a need to treat’ to describe benefits has significant drawbacks. Without understandable information about the probability of benefit and damage similarly, patient leaflets cannot aid patients in making educated decisions about taking medicine.
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Formal decision aids are available to aid decision‐making by patients, with a directory website of such aids available on the National Prescribing Centre (NPC) website 25. At the moment these are designed for only around 30 medications specifically circumstances. These are made for use by health professionals to help patients make decisions about medicines.
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