e-Participate

Nurses prescribing to diabetic patients have an opportunity to promote medicines adherence and improve patient outcome. The link between patients’ medication beliefs and their adherence is well established but studies have shown that this is rarely discussed in clinical consultations. This study examined the impact of an educational intervention with nurses to encourage exploration and discussion of patients’ beliefs about their medicines. The intervention was based on theories including self-efficacy theory and a patient centeredness model, and involved 4 one-day workshops with presentations, role play, video and reflection of practice. The workshops were run by a diabetic nurse consultant and a health psychologist. The researchers took audio recordings of participating nurses’ consultations to examine the frequency with which they gave patients the opportunity to discuss their medication beliefs, and conducted interviews with the nurses about their practice. One week after the intervention, nurses showed changes in their practice with increased asking about patients’ attitudes, beliefs, concerns and consequences of non-adherence. At 6 months there was still an increase in asking about medication concerns and beliefs about non-adherence. The nurses described changes in their awareness of patient beliefs and adoption of a more patient centred approach to their practice. Nurses found that the more practice and experience they gained of discussing medication beliefs, the more confident they became to do so in the future. Barriers to discussing medication beliefs included lack of time, unwillingness of patients, lack of support from colleagues and concerns about opening a ‘can of worms’.

The study has been published in the International Journal of Nursing Studies:

Latter, Sibley, Skinner et al (2010) The impact of an intervention for nurse prescribers on consultations to promote patient medicine-taking in diabetes: A mixed methods study. International Journal of Nursing Studies 47 1126-1138