Table 2.
Participants' Perceptions of Patient Involvement in Medication Decision Making
| Variability in perceptions of patients' role in decision making |
| Subtheme: patients do not want to be part of the decision making |
| Passive acceptance; want the doctor to tell them what to do |
| Fear and anxiety regarding illnesses; illness is overwhelming |
| Trust and confidence in the doctor means you should accept what the doctor says |
| Subtheme: patients cannot be a part of decision making |
| Patient is powerless and not taken seriously |
| Patients lack the knowledge to participate |
| Doctor should know what she is doing |
| People who do not trust the doctor will keep things from him |
| Subtheme: patients can and should participate in medication decision making |
| Patient is the one who knows her body and self |
| Patients have a responsibility to learn about their diseases and medications |
| Finding the right medications is a process of trial and error |
| Trust and confidence in the doctor facilitates participation |
| Medication use should be based on individual health goals |
| Doctor's attitudes and behaviors facilitate or impede patient participation |
| Subtheme: doctor's negative attitudes and behaviors impede participation |
| Some doctors are perceived as uncaring and unconcerned, abrupt, and not wanting to talk or knowing how to talk with patients; some doctors do not take the time to explain or provide enough information to allow patient participation; some doctors have an authoritative, intimidating manner |
| Patients perceive that doctors do not want patients to participate; perceive that doctors do not want to be questioned |
| Subtheme: doctors who communicate well encourage participation |
| Doctor behaviors that encourage participation include being straightforward in answering questions, giving patients a chance to talk, gearing information to the patient, adopting an unhurried and nonintimidating manner |
| It helps participation if the doctor knows the patient |
| Doctors have to appear receptive to patient input and involvement; ask about the patients' concerns, and tell patients that they have choices |
| Subtheme: doctors' focus on treating individual diseases and numbers was perceived as impeding patient participation in medication decision making |
| Health care system and logistical factors facilitate or impede participation |
| Subtheme: involvement of other people facilitates shared decision making |
| Pharmacists can help explain medications and expected effects |
| Support staff (e.g., nurse, social worker, aide) can supplement the patient's interaction with the doctor and aid communication |
| Bringing someone to the doctor's visit (to back them up) can help |
| Subtheme: the health care system is not structured to allow participation in decision- making |
| Not enough time; no reimbursement for the time it takes |
| Cannot chose a doctor with whom can be an active participant |
| Subtheme: medication decision making is too complex to allow anyone (doctor or patient) to make informed decision making |
| Information changing all the time; no one can keep up |
| Overspecialization of doctors; doctors only know their own area |
| Patients go to several physicians; no one has the overall plan or decision making |