Shared Decision-Making in Medications for Elderly Patients with Multi-Morbidities: A Phenomenological Study.

Abstract

Objective: To explore the willingness, needs, and factors influencing participation in medication decision-making among elderly patients with multi-morbidities, caregivers, and healthcare professionals.

Methods: A phenomenological research method was used to conduct semi-structured interviews with elderly patients with multi-morbidities, caregivers, and healthcare professionals. The purposive sampling method was used to select geriatric patients with multi-morbidities, their caregivers, and healthcare workers from March to July 2024 in the Geriatrics, Cardiology, Endocrinology, Respiratory, and Nephrology Departments of a tertiary hospital in Shanxi Province as the study subjects. The Colaizzi 7-step analysis method was used to analyze, summarize, and refine themes from the interview data.

Results: Twelve elderly patients with multi-morbidities, nine caregivers, and seven healthcare professionals were interviewed. Three themes and nine sub-themes were identified, as follows: (1) willingness to participate in decision-making (large differences in willingness and discrepancies between willingness and reality); (2) the current status of multi-morbidity management (lack of guidelines, healthcare systems and decision-making support systems); and (3) factors influencing participation in decision-making (bias in the power structure, lack of information exchange, insufficient knowledge and awareness of shared decision-making by healthcare workers, differences in patients' self-management initiative and medication-focused motivations).

Conclusion: Elderly patients with multi-morbidities were affected by multiple impediments to participation in medication decision-making. Healthcare professionals should continue to improve their shared decision-making awareness and ability, provide patients with targeted decision-making needs, solve decision-making problems, and promote the implementation of shared decision-making in elderly patients with multi-morbidities.