Repetitions in online doctor-patient communication: Frequency, functions, and reasons

Participation in medication safety of older-adult patients with chronic disease during the transition from hospital to home: a descriptive qualitative study

BACKGROUND

Medication safety issues occur frequently among older-adult patients with chronic diseases during the transition from the hospital to their homes. Patient participation in medication safety has been found to be an effective measure for improving patient safety. However, few studies have been conducted on the safety of older-adult patients with chronic disease during the hospital to family transition period. This study aimed to understand the experiences and perceptions of such patients regarding participation in medication safety during the hospital to family transition period and to explore the actual situation and obstacles during this period in the Chinese context.

METHODS

A descriptive, qualitative research approach was adopted using purposive sampling. Eighteen patients with chronic disease (aged 61-84 years) participated, all of whom were in the period of transition from hospital to home. Data were collected through semi-structured face-to-face interviews and analysed using directed qualitative content analysis.

RESULTS

Four themes and 12 sub-themes were identified in this study. The four themes were participation in medication decision-making, participation in medication self-management, participation support, and barriers to patient participation.

CONCLUSIONS

Patient participation is important in ensuring medication safety during the hospital to family transition period. This study highlights that older-adult patients' participation in medication safety includes three aspects: participation in medication decision-making, participation in medication self-management, and participation support. Health literacy, medical communication, and family care support are the key factors affecting patient participation in medication safety. Effective intervention strategies for this patient group during the transition period would target improving patients' cognition, health literacy, doctor-prescription communication, and family care support to encourage patients to be more actively involved in the process of drug treatment.

Online Self-Presentation by Traditional Chinese Medicine and Western Medicine Medical Professionals in China

Despite increasing research that examines language features of online medical consultation (OMC) conversations in China, limited attention has been directed to how medical professionals purposefully present themselves in their biographies on OMC websites, an emerging genre of health communication, with even fewer comparative studies on traditional Chinese medicine (TCM) and Western medicine (WM) medical professionals in this regard. To fill these gaps, this study compares the personal claims and self-presentational strategies used in TCM and WM medical professionals' biographies on a Chinese OMC website. It is found that while Chinese TCM and WM medical professionals present themselves in similar ways, they also demonstrate some important differences. The similarities may be driven by their shared goal of building trust in the OMC context, whereas the differences may be ascribed to TCM-WM differences in clinical philosophies, education histories, clinical cultures, and medical practices.

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

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.