Understanding the meaning of medication to patients – the medication experience – is fundamental to the achievement of good outcomes. Although not well researched and explained, an excellent summary was published by Sarah Shoemaker, now more than 5 years ago.
Sarah split the medication experience into four sections:
A meaningful encounter- where a medicine is offered in the context of a condition
Bodily effects – where the patient experiences the effects of the medication within their body
Unremitting nature – where the patient questions the need for the medicine, particularly if it is to be taken long term
Exerting control – where a patient exerts control on the medicine, having gained ‘expertise’ of the medicine in their own body.
Using this model to understand patient’s experiences and to understand a patient’s medication experience and medication-taking behaviours is important in structuring interventions to support appropriate compliance through meeting medication-related needs. Patients will move through these stages, and it is important to understand where individual patients are to be able to improve their medication experience and improve their outcomes in partnership.
We must recognise that not all medicines are taken as prescribed. In some cases the outcome may actually be improved, but in many the outcome may be worse. The aim of medicines optimisation is to ensure that the best possible outcomes are achieved for patients.
The most wasteful medicine is one used in a manner where valued benefits and outcomes are not achieved.