Mapping Perceptions of Lupus Medication Decision-Making Facilitators: The Importance of Patient Context

Academic Article

Abstract

  • © 2016, American College of Rheumatology Objective: 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. Methods: 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. Results: 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. Conclusion: 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.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Qu H; Shewchuk RM; Alarcón G; Fraenkel L; Leong A; Dall'Era M; Yazdany J; Singh JA
  • Start Page

  • 1787
  • End Page

  • 1794
  • Volume

  • 68
  • Issue

  • 12