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Title:	Pharmacist-patient consultations : attitudes toward concordance and patient-centred approaches in Medication Therapy Adherence Clinics (MTAC)
Supervisor:	Chong Wei Wen, Dr.
Keywords:	Universiti Kebangsaan Malaysia -- Dissertations Dissertations, Academic -- Malaysia Pharmacists Pharmacy Service Hospital
Issue Date:	22-Apr-2021
Description:	Patient-centred care (PCC) is described as patient-provider collaborative care, where patients' individual preferences and needs guide any treatment decision-making. Concordance is another term that shares similar aspects to PCC, with the focus being on patients' medication-taking behaviour. A PCC approach by all healthcare providers, including pharmacists, is important and has been shown to improve medication adherence. Nonetheless, studies on the application of PCC in pharmacist' consultations in Malaysia are still limited. Therefore, this research aimed to assess and explore PCC and attitudes toward concordance among Medication Therapy Adherence Clinic (MTAC) pharmacists and patients, as well as evaluate pharmacists' patient-centred communication. This research consisted of three parts. First, a quantitative study was conducted among 389 patients and 93 MTAC pharmacists to assess attitudes towards concordance and patient decision self-efficacy. Second, a qualitative interview study was performed among 17 patients and 18 pharmacists, to explore perceptions of important aspects and factors influencing PCC application in pharmacy practice. Lastly, a training module on communication for pharmacists was developed based on motivational interviewing and the Four Habits Model, a patient-centred communication framework. A single-group, quasi-experimental patient-centred communication training was conducted among 38 MTAC pharmacists. Results from the quantitative study showed that pharmacists and patients were generally receptive towards concordance. Ethnicity, perceived involvement in decision-making, number of medications, and attitude towards concordance were significant predictors of patient's decision self-efficacy (p<0.05). In the qualitative study, five themes emerged pertaining to important aspects of PCC, namely, mutual understanding, respecting individuality, communication style, information-giving, and medication decision-making. The factors affecting PCC application were cited to be patient-related, pharmacist-related, and institution-related. Analysis of the pharmacists' post-training communication data revealed significant improvements in several patient-centred communication behaviours, attitudes towards concordance, and communication self-efficacy. Overall, findings from this research highlighted the importance of PCC in improving patient care in pharmacy MTAC settings. The developed module and training program could potentially serve as a basis for applying patient-centred communication and concordance in pharmacist consultations,Ijazah Doktor Falsafah (PhD)
Pages:	318
Call Number:	QV21.N576p 2021 9 tesis
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Pharmacy / Fakulti Farmasi

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