Participatory pharmacotherapy: 10 strategies for enhancing adherence
Engaging patients as partners in treatment can improve outcomes.
10. Harness the placebo effect and the power of suggestion to increase chances of achieving the best treatment outcomes. In a previous article,12 I reviewed the principles of recognizing and enhancing the placebo effect and the power of suggestion to improve the chances of achieving better pharmacotherapy outcomes. When practicing participatory pharmacotherapy, clinicians are consciously aware of the power embedded in their words and are careful to use language that enhances the placebo effect and the power of suggestion when prescribing medications. Use the patient’s own language as a way of pacing yourself to the patient’s description of his or her distress. For example, Ms. R, a 42-year-old mother of 3, describes her experiences seeking help for her anxiety and depression, stating that she has not yet found the right combination of medications that provide benefits with tolerable side effects. Her clinician responds by focusing on the word “yet” (pacing) stating, “even though you have not yet found the right combination of medications to provide the most desirable benefit of beginning healing and restoring your hope, I promise to work with you and together we will try to achieve an improvement in your overall health and well-being.” This response includes several positive words and suggestions of future success, which are referred to as leading.
Not all patients will respond to participatory pharmacotherapy. Some factors will make patients good candidates for this approach, and others should be considered exclusionary qualities (Table 2).
Bottom Line
“Participatory pharmacotherapy” involves identifying patients as partners in the process of treatment choice and decision-making, encouraging them to provide their opinions regarding medication use, and making patients feel they have been heard and understood. This technique emphasizes forming a therapeutic alliance with the patient to improve patients’ adherence to pharmacotherapy and optimize treatment outcomes.
Related Resources
- Haynes RB, Ackloo E, Sahota N, et al. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;16(2);CD000011.
- Mahone IH. Shared decision making and serious mental illness. Arch Psychiatr Nurs. 2008;22(6):334-343.
- Russel CL, Ruppar TM, Metteson M. Improving medication adherence: moving from intention and motivation to a personal systems approach. Nurs Clin North Am. 2011;46(3):271-281.
- Tibaldi G, Salvador-Carulla L, Garcia-Gutierrez JC. From treatment adherence to advanced shared decision making: New professional strategies and attitudes in mental health care. Curr Clin Pharmacol. 2011;6(2):91-99.
Drug Brand Name
Clonazepam • Klonopin
Disclosure
Dr. Torem reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
