Participation in decision making when starting long-term medication : patients´ experiences

Rationale, aim and objective: To achieve the beneficial effect of drug treatment and reduce unnecessary healthcare costs, patients must be involved in shared decision-making. The aim of this study was to describe patient experiences of participation in decision-making when commencing long-term medication. Method: Nine patients at 2 healthcare centers were semi-structured interviewed about their experiences, beliefs and feelings about their participation in the decision to commence long-term medication. Data were analyzed by a qualitative content method. Results: Respondents stated that participating in decision-making in drug treatment requires knowledge of the relevant area and requires trust in the physician. The respondent’s responsibility and motivation were found to facilitate adherence to drug treatment. Conclusion: Patients sought participation in the decision-making of long-term medication use and expressed a needed for adequate time as part of this dialogue. If they lacked sufficient knowledge, patients wanted relevant and useful information from the physician. To experience trust in the physician through a ‘good’ encounter increases the possibility for participation and enhancement of medication adherence. In order to participate in decision-making, the patient needs the physician’s encouragement. It is contended that direct attempts to involve the patient in decision-making on long-term drug use directly increases the person-centeredness of clinical care.