Empower

This part of the consultation is fundamental to understanding a patient’s motivation for taking a medicine. Ask questions such as: 

• "What is the most important thing to you about this medicine?"

This will help you to understand why they want to take the medicine, which is important in supporting adherence. We know that up to 50 per cent of medicines aren’t taken as intended, so it is better to find out that someone doesn’t want to take the medicine at this stage.  

It is critical to help patients find their internal motivation for taking their medicines ("I want to find a way to remember to take my medicine because I know it will reduce my risk of xxx") rather than their external motivation ("the doctor told me to").

Some people may show ambivalence about medicines-taking. You can use the opportunity to provide evidence to help patients balance the risks and benefits of their treatment. Helpful hints include asking:

• "What do you know about the benefits of taking this medicine?" (Why were you prescribed it?)
• "What are you worried about with this medicine?"

When talking about risks and benefits, it can be helpful to replace the term "risk" with "likelihood" or "chance" of side-effects, which has a more neutral connotation than the word "risk".

It is also important to acknowledge that no one can be certain who might benefit or come to harm from medicines. You might like to say:

• "Most people have no problem with this medicine but there is a small chance/likelihood that it could cause dizziness" (or any common side-effect).

When talking about the chance of a side-effect, remember to always frame this as both positive and negative. For example:

• "About one in 10 people experience dizziness when first starting this medicine, which means nine out of 10 do not experience any dizziness."

When discussing a rare but severe side-effect, combine risk and uncertainty in your conversation:

• "As we can’t know who will be affected, we tell people about particular side-effects where there is a very small chance of [name it] happening – so if this does happen, you’ll know what to do."