Table 1.
Tops tips for discussion between the healthcare professional and the patient about treatment burden
| For the patient | For the healthcare professionals |
| Prepare questions and practice explaining about concerns before your consultation | Patients with chronic conditions have to adjust to the implications of the diagnosis on their life and lifestyle. Be sensitive with how you communicate this |
| Take a carer or friend with you to consultations. Brief them about your questions and concerns and ask them to help listen to the information provided | Encourage the patient to bring a companion; and encourage them to write down key information |
| Think about treatment goals and be clear what is important to you (e.g. being less breathless, being able to run) | Discuss lifestyle behaviours of the patient: what are their priorities? This will help to guide the best medication, taking into account issues such as side-effects, monitoring requirements, cost, impact on driving and family |
| Ask for the names of other HCPs (e.g. specialist nurse) who you can discuss this with in more detail in the future | Provide details, where possible, for a nurse or pharmacist who will have the time to have a longer/further discussion with the patient; but ensure the messages are consistent |
| Ensure that you understand why a treatment is being recommended and ask for further information to help you make decisions about this if required | Explain clearly what treatments are available so patients can make an informed choice. Remember that limited health literacy is common even without specific challenges or learning disabilities |
| Read and learn from trusted/reputable resources. Ask about good sources of information | Provide the patient with details of a trusted patient organisation or peer-support group from which they can gain input and further advice |
| Ask about side-effects, and about how likely they are to happen. Check what you should do if you are experiencing a side-effect | Do not wait to be asked about side-effects. Tell patients about anything common or potentially serious and ensure they know what to do if a problem develops |
| Explain any factors that you feel may make it harder for you to take your medicines or follow the treatment recommendations given | Explore non-adherence in a non-judgemental way to agree with the patient how to gain benefit from treatment, personalised to the individual's circumstances |
| Ask if you think that one of your medications is no longer needed or is causing side-effects | Agree with the patient if specific medications can be stopped or regime modified (using tools such as STOPP/START). Regularly review treatments to de-prescribe, if appropriate |
| Ask about written information (such as action plans) that could help you follow advice | Provide simple, written follow-up advice, including self-management plans (e.g. asthma action plans [8]), which can empower patients to be partners in their care |
| Medication reviews are important for safe use of medications – use them to discuss any concerns that you have about your treatment | Using a qualitative measure of treatment burden at annual reviews could offer an opportunity to raise issues that are bothering the patient [9] |