PARTNER INFLUENCE ON ASTHMA PATIENTS' DECISION MAKING ABOUT PRESCRIPTION DRUGS

Purpose:

Little is known about the role spouses or partners play in patients’ decision making about medications.  This study examined how partners’ are involved with and influence drug decision making among individuals diagnosed with asthma, and addressed the following research questions: (1) What factors are important to patients and partners in drug decisions?; (2) What are patients’ and partners’ preferences for partner involvement in decision making?; (3) What prompts patient/partner discussions about drugs and what do they discuss?; and (4) What kinds of discussions are helpful /not helpful to patients in making decisions?

Methods:

We conducted focus groups with 47 individuals diagnosed with asthma (n= 3 groups) and partners of individuals with asthma (n=3 groups) in Bethesda, MD and Raleigh NC.  We used structured interview guides to probe drug decision making and partner involvement.  We transcribed the audio recordings and used a Framework Analysis approach to coding and analyzing the qualitative data.

Results:

The factors both patients and partners most frequently consider in making drug decisions are risks and side effects, cost and insurance coverage, effectiveness, and ease of use. Most partners played some role in the patient’s asthma care and drug decision making, including seeking drug information, encouraging the patient to ask the doctor questions, accompanying the patient to doctor appointments, and discussing costs and insurance coverage. Patients and partners often discuss side effects and weigh the risks and benefits of drug options. In some cases, patients are more concerned about side effects and their partner provides reassurance; in other cases partners have greater concerns.  Patients can feel pressured when their partner has different views about using drugs vs. lifestyle or “natural” methods of asthma management. The most helpful discussions are when partners provide emotional support and help patients think through their choices. Some partners considered drug decisions to be strictly between the patient and the doctor and are minimally involved. Overall, women were more involved than men with their partner’s care including drug decisions.  Partners tended to be less involved if the patient had long-term asthma (especially if diagnosed prior to becoming a couple) and if symptoms were less severe.

Conclusion:

                Interventions to support patients’ informed decision making about medications should take into account their partners’ influence and role.