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- Title
Mapping Perceptions of Lupus Medication Decision-Making Facilitators: The Importance of Patient Context.
- Authors
Qu, Haiyan; Shewchuk, Richard M.; Alarcón, Graciela; Fraenkel, Liana; Leong, Amye; Dall'Era, Maria; Yazdany, Jinoos; Singh, Jasvinder A.; Alarcón, Graciela
- Abstract
<bold>Objective: </bold>Numerous factors can impede or facilitate patients' medication decision-making and adherence to physicians' recommendations. Little is known about how patients and physicians jointly view issues that affect the decision-making process. Our objective was to derive an empirical framework of patient-identified facilitators to lupus medication decision-making from key stakeholders (including 15 physicians, 5 patients/patient advocates, and 8 medical professionals) using a patient-centered cognitive mapping approach.<bold>Methods: </bold>We used nominal group patient panels to identify facilitators to lupus treatment decision-making. Stakeholders independently sorted the identified facilitators (n = 98) based on their similarities and rated the importance of each facilitator in patient decision-making. Data were analyzed using multidimensional scaling and hierarchical cluster analysis.<bold>Results: </bold>A cognitive map was derived that represents an empirical framework of facilitators for lupus treatment decisions from multiple stakeholders' perspectives. The facilitator clusters were 1) hope for a normal/healthy life, 2) understand benefits and effectiveness of taking medications, 3) desire to minimize side effects, 4) medication-related data, 5) medication effectiveness for "me," 6) family focus, 7) confidence in physician, 8) medication research, 9) reassurance about medication, and 10) medication economics.<bold>Conclusion: </bold>Consideration of how different stakeholders perceive the relative importance of lupus medication decision-making clusters is an important step toward improving patient-physician communication and effective shared decision-making. The empirically derived framework of medication decision-making facilitators can be used as a guide to develop a lupus decision aid that focuses on improving physician-patient communication.
- Subjects
CLUSTER analysis (Statistics); COMMUNICATION; DECISION making; SENSORY perception; PHYSICIAN-patient relations; SYSTEMIC lupus erythematosus; PATIENT participation; PSYCHOLOGY
- Publication
Arthritis Care & Research, 2016, Vol 68, Issue 12, p1787
- ISSN
2151-464X
- Publication type
journal article
- DOI
10.1002/acr.22904