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Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations

Weiss, Marjorie C.; Platt, Jo; Riley, Ruth; Chewning, Betty; Taylor, Gordon; Horrocks, Susan; Taylor, Andrea

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Marjorie C. Weiss

Jo Platt

Ruth Riley

Betty Chewning

Gordon Taylor

Sue Horrocks
Occasional Associate Lecturer - CHSS

Andrea Taylor


UNLABELLED: Aim The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy.BACKGROUND: There are a range of ways for defining and measuring the process of concordance, or shared decision making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging. In the United Kingdom, nurses and pharmacists can now take on a prescribing role, engaging in shared decision making. Given the different professional backgrounds of GPs, NPs and PPs, this study sought to explore the process of shared decision making across these three prescriber groups.METHODS: Analysis of audio-recordings of consultations in primary care in South England between patients and GPs, NPs and PPs. Analysis of patient questionnaires completed post consultation. Findings A total of 532 consultations were audio-recorded with 20 GPs, 19 NPs and 12 PPs. Prescribing decisions occurred in 421 (79%). Patients were given treatment options in 21% (102/482) of decisions, the prescriber elicited the patient's treatment preference in 18% (88/482) and the patient expressed a treatment preference in 24% (118/482) of decisions. PPs were more likely to ask for the patient's preference about their treatment regimen (χ 2=6.6, P=0.036, Cramer's V=0.12) than either NPs or GPs. Of the 275 patient questionnaires, 192(70%) could be matched with a prescribing decision. NP patients had higher satisfaction levels than patients of GPs or PPs. More time describing treatment options was associated with increased satisfaction, adherence and greater perceived practitioner empathy. While defining, measuring and enabling the process of shared decision making remains challenging, it may have patient benefit.


Weiss, M. C., Platt, J., Riley, R., Chewning, B., Taylor, G., Horrocks, S., & Taylor, A. (2015). Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations. Primary Health Care Research and Development, 16(5), 513-527.

Journal Article Type Article
Publication Date Sep 1, 2015
Deposit Date Mar 2, 2015
Publicly Available Date Apr 1, 2016
Journal Primary health care research & development
Print ISSN 1463-4236
Electronic ISSN 1477-1128
Publisher Cambridge University Press (CUP)
Peer Reviewed Peer Reviewed
Volume 16
Issue 5
Pages 513-527
Keywords consultation, doctor patient relations, general practitioners, health communication, nurse practitioners, pharmacists
Public URL
Publisher URL


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