Participation of pharmacists and patients in web-based pharmaceutical care consultation based on MEDICODE

Abstract

Background: The participation of providers and patients in medical communication is the core element of shared decision making. Furthermore, web-based pharmaceutical care consultation is increasingly necessary, welcomed and popular.

Objective: This study aimed to analyze the participation of pharmacists and patients in web-based pharmaceutical care consultation, so as to form the promotion strategy for both parties' participation.

Methods: Data of pharmacist-patient encounters was obtained from the online platform 'Good Doctor Website' from March 31, 2012 to June 22, 2019. MEDICODE was employed to analyze the participation of pharmacists and patients in web-based pharmaceutical care consultation using dialogue ratio, the preponderance of initiative, and dialogical roles (information provider, listener, instigator and participant).

Results: This study included 121 pharmacist-patient encounters which discussed 382 specifically named medications. On average, 3.75 specific themes were discussed per medication. Among the 29 specific themes observed, 16 were initiated primarily by patients and 13 by pharmacists, 22 were primarily monologue, 6 were primarily dialogue, and 1 was a combination of the two. Pharmacists and patients were information providers or listeners in most content theme categories, such as possible main effect, possible adverse effect, instructions, warnings, adherence, designation, and observed adverse effect.

Conclusions: Pharmacists and patients exchanged less drug-related information in web-based pharmaceutical care consultation. The exchange had more patient-dominated behaviors and more of a monologue. Furthermore, pharmacists and patients were mainly information providers or listeners in communication. The participation of both parties was insufficient.

Keywords: Consultation; Internet; Medication; Participation; Pharmaceutical care.