The University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI 48109, USA.
Res Social Adm Pharm. 2012 Jul-Aug;8(4):321-32. doi: 10.1016/j.sapharm.2011.08.003. Epub 2012 Jan 4.
Pharmacy services are offered to patients, and often, they decline participation. Research is needed to better understand patients' unmet needs when taking prescribed medications.
To identify and characterize patients' unmet needs related to using prescribed medication for chronic conditions.
Focus groups of patients using prescription medication for chronic conditions discussed their experiences with medications, starting from initial diagnosis to ongoing management. Sessions involved 40 patients from 1 Midwestern U.S. state. Major themes were identified using content analysis.
Three major themes emerged. First, patients seek information to understand their health condition and treatment rationale. Patients form an illness perception (its consequence, controllability, cause, and duration) that dictates their actions. Second, patients desire to be involved in treatment decisions, and they often feel that decisions are made for them without their understanding of the risk-to-benefit trade-off. Third, patients monitor the impact of treatment decisions to determine if anticipated outcomes are achieved.
The results were consistent with Dowell's therapeutic alliance model (TAM) and Leventhal's common sense model (CSM). The TAM can be used to model the consultative services between pharmacists and patients. The impact of the new services (or interventions) can be evaluated using the CSM. Patients expressed a strong desire to be involved in their treatment decisions. The effectiveness of medication therapy management services may be enhanced if pharmacists build on patients' desire to be involved in their treatment decisions and assist them to understand the role of medications and their risks and expected outcomes within the context of the patients' perceptions of illness and desired coping strategies.
药剂师向患者提供服务，但患者常常拒绝参与。为了更好地了解患者在使用处方药物治疗慢性病时未得到满足的需求，需要开展相关研究。
确定并描述与使用慢性病处方药相关的患者未得到满足的需求。
参与研究的患者患有慢性病且正在使用处方药，研究采用焦点小组的形式，讨论他们从初始诊断到持续管理期间使用药物的经历。该研究在 1 个美国中西部州开展，共纳入了 40 名患者。采用内容分析法确定主要主题。
研究结果共出现 3 个主要主题。首先，患者寻求信息以了解自身健康状况和治疗原理。患者形成对疾病的认知（疾病的后果、可控制性、病因和持续时间），这决定了他们的行为。其次，患者希望参与治疗决策，他们常常感到自己没有理解风险-获益权衡，而决策是在他们不知情的情况下做出的。最后，患者监测治疗决策的影响，以确定预期结果是否得到实现。
研究结果与 Dowell 的治疗联盟模型（TAM）和 Leventhal 的常识模型（CSM）一致。TAM 可用于模拟药剂师与患者之间的咨询服务。可以使用 CSM 评估新服务（或干预措施）的效果。患者强烈希望参与其治疗决策。如果药剂师能够满足患者参与其治疗决策的愿望，并帮助他们了解药物的作用及其在患者对疾病的认知和预期应对策略下的风险和预期结果，那么药物治疗管理服务的效果可能会得到增强。
