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Medicine discussion between nurse prescribers and people with diabetes: an analysis of content and participation using MEDICODE

Medicine discussion between nurse prescribers and people with diabetes: an analysis of content and participation using MEDICODE
Medicine discussion between nurse prescribers and people with diabetes: an analysis of content and participation using MEDICODE
Aim: this paper is a report of a study to identify the content of, and participation in, medicine discussion between nurse prescribers and people with diabetes in England.

Background: diabetes affects 246 million people worldwide and effectively managing medicines is an essential component of successful disease control. There are now over 20,000 nurse independent prescribers in the UK, many of whom frequently prescribe for people with diabetes. With this responsibility comes a challenge to effectively communicate with patients about medicines. National guidelines on medicines communication have recently been issued, but the extent to which nurse prescribers are facilitating effective medicine-taking in diabetes remains unknown.

Methods: a purposive sample of 20 nurse prescribers working with diabetes patients audio-recorded 59 of their routine consultations and a descriptive analysis was conducted using a validated coding tool: MEDICODE. Recordings were collected between January-July 2008. The unit of analysis was the medicine.

Results: 260 instances of medicine discussion identified in the audio-recordings were analysed. The most frequently raised themes were ‘medication named’ (raised in 88.8% of medicines), ‘usage of medication’ (65.4%) and ‘instructions for taking medication’ (48.5%). ‘Reasons for medication’ (8.5%) and ‘concerns about medication’ were infrequently discussed (2.7%). Measures of consultation participation suggest largely dyadic medicine discussion initiated by nurse prescribers.

Conclusion: MEDICODE discussion themes linked to principles of recent guidelines for effective medicine-taking were infrequently raised. Medicine discussion was characterised by a one statement-one response style of communication led by nurses. Professional development is required to support theoretically-informed approaches to effective medicines management.


What is already known about this topic:

• To optimise the available skills of the workforce and improve patient access to medicines, the number of nurses in England with a prescribing qualification has continued to increase.

• Recommendations for professionals to enact effective medicine discussion exist and indicate that patients’ medicine beliefs are a strong predictor of medicine-taking behaviour.

• Little is known about medicine discussions, content and levels of participation, between nurse prescribers who regularly prescribe diabetes medicines and diabetes patients.

What this paper adds:

• This structured assessment of medicine communication indicated that nurse prescribers primarily focused on instruction-based medicine communication, e.g. instructions for taking medicine, usage of medicine.

• Key discussion themes linked to current recommendations for effective medicine discussion were infrequently raised during routine consultations.

• The nature of nurse prescribers’ medicine discussion was in the form of dyadic discussion and largely initiated by nurses.

Implications for practice and/or policy:

• The content of nurse prescribers’ discussion about medicines suggests that practice is currently limited and is not likely to fully enhance patient medicine-taking.

• There is a need for continuing professional development for nurse prescribers to facilitate their exploration of patients’ medicine beliefs within a patient-centred approach.
diabetes, medicine beliefs, medicine-taking, nurse prescribing, participation, provider-patient communication
0309-2402
2323-2336
Sibley, Andrew
afe7cc9d-614e-4cb1-b080-8ca7df54ae40
Latter, Susan
83f100a4-95ec-4f2e-99a5-186095de2f3b
Lussier, Marie-Therese
cec0010f-4612-40ff-b54b-db891b46f72d
Richard, Claude
f3fdd549-ec3b-4cbd-82c6-13537c4fe59b
Roberge, Denis
3163533e-ccb7-488a-8593-7138224de65c
Skinner, Timothy C.
86d9ad2a-4c77-41f9-918e-214d420f1afe
Cradock, Sue
1e06073e-3809-4392-a4cb-1dacb5a66f30
Zinken, Kasia
9cc30a56-e37c-412e-8ec6-ebb36ae20d7e
Sibley, Andrew
afe7cc9d-614e-4cb1-b080-8ca7df54ae40
Latter, Susan
83f100a4-95ec-4f2e-99a5-186095de2f3b
Lussier, Marie-Therese
cec0010f-4612-40ff-b54b-db891b46f72d
Richard, Claude
f3fdd549-ec3b-4cbd-82c6-13537c4fe59b
Roberge, Denis
3163533e-ccb7-488a-8593-7138224de65c
Skinner, Timothy C.
86d9ad2a-4c77-41f9-918e-214d420f1afe
Cradock, Sue
1e06073e-3809-4392-a4cb-1dacb5a66f30
Zinken, Kasia
9cc30a56-e37c-412e-8ec6-ebb36ae20d7e

Sibley, Andrew, Latter, Susan, Lussier, Marie-Therese, Richard, Claude, Roberge, Denis, Skinner, Timothy C., Cradock, Sue and Zinken, Kasia (2011) Medicine discussion between nurse prescribers and people with diabetes: an analysis of content and participation using MEDICODE. Journal of Advanced Nursing, 67 (11), 2323-2336. (doi:10.1111/j.1365-2648.2011.05686.x). (PMID:21592189)

Record type: Article

Abstract

Aim: this paper is a report of a study to identify the content of, and participation in, medicine discussion between nurse prescribers and people with diabetes in England.

Background: diabetes affects 246 million people worldwide and effectively managing medicines is an essential component of successful disease control. There are now over 20,000 nurse independent prescribers in the UK, many of whom frequently prescribe for people with diabetes. With this responsibility comes a challenge to effectively communicate with patients about medicines. National guidelines on medicines communication have recently been issued, but the extent to which nurse prescribers are facilitating effective medicine-taking in diabetes remains unknown.

Methods: a purposive sample of 20 nurse prescribers working with diabetes patients audio-recorded 59 of their routine consultations and a descriptive analysis was conducted using a validated coding tool: MEDICODE. Recordings were collected between January-July 2008. The unit of analysis was the medicine.

Results: 260 instances of medicine discussion identified in the audio-recordings were analysed. The most frequently raised themes were ‘medication named’ (raised in 88.8% of medicines), ‘usage of medication’ (65.4%) and ‘instructions for taking medication’ (48.5%). ‘Reasons for medication’ (8.5%) and ‘concerns about medication’ were infrequently discussed (2.7%). Measures of consultation participation suggest largely dyadic medicine discussion initiated by nurse prescribers.

Conclusion: MEDICODE discussion themes linked to principles of recent guidelines for effective medicine-taking were infrequently raised. Medicine discussion was characterised by a one statement-one response style of communication led by nurses. Professional development is required to support theoretically-informed approaches to effective medicines management.


What is already known about this topic:

• To optimise the available skills of the workforce and improve patient access to medicines, the number of nurses in England with a prescribing qualification has continued to increase.

• Recommendations for professionals to enact effective medicine discussion exist and indicate that patients’ medicine beliefs are a strong predictor of medicine-taking behaviour.

• Little is known about medicine discussions, content and levels of participation, between nurse prescribers who regularly prescribe diabetes medicines and diabetes patients.

What this paper adds:

• This structured assessment of medicine communication indicated that nurse prescribers primarily focused on instruction-based medicine communication, e.g. instructions for taking medicine, usage of medicine.

• Key discussion themes linked to current recommendations for effective medicine discussion were infrequently raised during routine consultations.

• The nature of nurse prescribers’ medicine discussion was in the form of dyadic discussion and largely initiated by nurses.

Implications for practice and/or policy:

• The content of nurse prescribers’ discussion about medicines suggests that practice is currently limited and is not likely to fully enhance patient medicine-taking.

• There is a need for continuing professional development for nurse prescribers to facilitate their exploration of patients’ medicine beliefs within a patient-centred approach.

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e-pub ahead of print date: 18 May 2011
Published date: November 2011
Keywords: diabetes, medicine beliefs, medicine-taking, nurse prescribing, participation, provider-patient communication
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 175917
URI: http://eprints.soton.ac.uk/id/eprint/175917
ISSN: 0309-2402
PURE UUID: 6e3438c6-7b96-47a3-9a13-9f7bb200aecf
ORCID for Andrew Sibley: ORCID iD orcid.org/0000-0002-2503-5432
ORCID for Susan Latter: ORCID iD orcid.org/0000-0003-0973-0512

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Date deposited: 01 Mar 2011 15:00
Last modified: 14 Mar 2024 02:44

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Contributors

Author: Andrew Sibley ORCID iD
Author: Susan Latter ORCID iD
Author: Marie-Therese Lussier
Author: Claude Richard
Author: Denis Roberge
Author: Timothy C. Skinner
Author: Sue Cradock
Author: Kasia Zinken

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