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Research project: Improving medicine-taking in diabetes care: An evaluation of an educational intervention for use by nursing prescribers - Dormant - Dormant

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The problem of ineffective and inefficient medicine-taking in diabetes and in chronic disease more generally remains a significant one: it is estimated that 50% of people with long term disease do not take their medicines as prescribed (Department of Health 2000).

Overview

Patients' beliefs about their medications has been recognised as an important factor in guiding patients' medicine-taking behaviour (Horne et al. 1999) and nurses who prescribe medicines in diabetes care have the opportunity to improve patient medicine-taking behaviour during consultations. A systematic and ongoing dialogue between the nurse and patient regarding their beliefs about medicines would allow for an exploration of rational and irrational patient beliefs at the new referral stage and over time. However, research has indicated that nurses do not always explore these issues and need extra training in this important area (Latter et al. 2007b).

Main question(s)

To develop and deliver a theory-based educational intervention for nurse prescribers designed to influence diabetes patients' beliefs about medicines (BaM) in order to improve the effectiveness of their medicine-taking.

  • To examine changes in nurses' communication skills following the educational intervention (via audio-recording consultations).
  • To investigate nurse prescribers' views on implementing the BaM approach in practice, including identification of the successful components of the educational intervention, and the factors that influence adoption of the approach in practice.
  • To investigate patients' views of the value, impact and effectiveness of education about medication within nurses' prescribing consultations.

Methodology

The study employs quantitative (structured observation) and qualitative methods (semi-structured interviews with diabetes patients & nurse prescribers) in a mixed methods concurrent triangulation design (Tashakkori & Teddlie 2003). It will examine the impact of a theory-based, BaM educational intervention on nurse prescribers' consultations with diabetes patients. The method and process of training will be based on social cognitive theory (Bandura, 1997), to develop nurses' confidence and consultation skills with regard to facilitating patients' medicine management.

Main outcomes 

 Knowledge about the impact of the education on nurse prescribers' consultation communication behaviour, via the structured observations measures:
(a) MEDICODE (Richard & Lussier, 2006)
(b) RIAS (Roter, 2002)
(c) Framework Analysis (Spencer et al. 2003) 

  •  Evidence about nurse prescribers' fidelity to the educational principles (via the structured observations).
  •  Evidence about patients' and nurse prescribers' views on the content and acceptability of the educational intervention (via nurse prescriber & patient semi-structured interviews).   

Project team

Sue Latter, Timothy C Skinner, Sue Cradock, Andrew Sibley

Project funder

Diabetes UK

Related research groups

Health Work and Systems

Key Publications

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