Do people want to participate in decisions concerning their medicines?
Health and medication literacy are important factors linked to the outcomes of medical treatment (Table 1). Health literacy has been assessed in several countries all over the world and has been found to be limited. The level of health literacy may influence the communication between healthcare professionals and patients. It is known that patients with low health literacy ask their doctors fewer questions and may experience less participatory decision making when communicating with the doctor. Less is known about the level of medication literacy, even though medicines are widely used in the treatment of most conditions.
Our study aimed to find out whether the level of medication literacy is associated with the desire of patients to participate in decision making concerning their medications. We sent a questionnaire to randomly selected people in two countries at the geographical extremes of Europe, Finland, having a Nordic culture and Malta, having a Mediterranean culture. We had an adequate number of people responding, when considering the size of the countries participating. In Finland, we received answers from 3 190 persons, and in Malta .from 820 persons.
We assessed health and medication literacy with the following three statements:
- How often do you have problems understanding things related to your medical condition because of difficulty understanding written material? The respondent could choose from the following categories: always, often, sometimes, occasionally and never.
- How often do you find it difficult to understand the instructions on the package insert, found inside the medicine package? The respondent could choose from the following categories: always, often, sometimes, rarely, never.
- How well, in your opinion, are you usually able to follow instructions, printed on the pharmacy label? The respondent could choose from the following categories: very well, fairly well, moderately, fairly poorly, extremely poorly.
We assessed the desire to participate in decision making concerning medications with another three statements. The respondent could choose from the following categories: fully agree, fairly agree, fairly disagree, totally disagree and don’t know.
- I want to discuss different treatment options with the doctor
- I want to discuss the choice of medicine with the doctor
- I want to decide the choice of medicine together with the doctor
We found out that many persons answering our questionnaire said that they have problems in understanding health related written materials, including package inserts that can be found in the medicine packages. Often those were men and elderly (65–79 years of age), who reported these problems.
The majority of the persons answering our questionnaire in both countries wanted to discuss different treatment options with the doctor as seen in Figure 1. Many also wanted to discuss about the choice of medicine, and even decide about the choice of medicine together with the doctor. Women and Maltese people were more willing to participate in these decisions than men and Finnish people. Even so, the desire to participate was high among all respondents. An interesting finding was that those who reported having problems in understanding package inserts were also more often interested in participating in decision making concerning their medications.
Our findings suggest that doctors, pharmacists and other health care professionals should always discuss medicines with the patients, and to give them a possibility to ask questions about their medicines. On many occasions, written information may be too difficult. Moreover, health care professionals should provide all patients with the possibility to participate in decision making regarding their medicines.
Cordina M 1, Hämeen-Anttila K 3, Lauri J 2, Tabone S 1, Enlund H 3
1Medicines Use Research Group, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Malta
2Department of Mathematics, Faculty of Science, University of Malta, Malta
3Finnish Medicines Agency FIMEA, Finland, P.O.Box 55, 00034 FIMEA, Finland
Health and medication literacy and the desire to participate in pharmacotherapy decision making – comparison of two countries.
Cordina M, Hämeen-Anttila K, Lauri J, Tabone S, Enlund H
Res Social Adm Pharm. 2018 Sep