Improving Medication Adherence: How to Talk With Patients About Their Medications by Shawn Christopher Shea, C. Everett Koop

Improving Medication Adherence: How to Talk With Patients About Their Medicationsby Anonymous

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05/25/2008: As an internist who has specialized in pulmomary medicine, and who also enjoys teaching medical and nursing students, I have fallen in love with this timely and intriguing book. When a reviewer tells you a book is unique, it's usually not true. When they tell you it is remarkably practical, it's often an exaggeration. When they say it is beautifully written and fun to read and a 'must buy,' you know it's hype. Except with this book. 'Improving Medication Adherence: How to Talk with Patients About Their Medications' by Shawn Christopher Shea is unique, remarkably practical, beautifully written, fun to read, and I honestly believe that every medical and nursing student in the world should read it. As physicians, nurses, physician assistants, and clinical pharmacists, we all know the critical importance of improving medication adherence. In this book, Dr. Shea's third outstanding textbook, a highly acclaimed innovator in clinical interviewing has taken the time to ask thousands of primary care clinicians and mental health professionals what specific interviewing 'tricks of the trade' help them to motivate patients to take medications as prescribed. Nothing 'Ivory Towered' here. He has taken the best of these 'best practices' from front-line clinicians and woven them into a logical framework for enhancing what he calls 'medication interest.' With a lively and concise writing style, Shea takes the reader into an engaging exploration of exactly how patients both intellectually and emotionally decide whether or not to take a medication and ultimately to stay on it. With numerous case examples he shows how to use a framework for understanding called the 'Choice Triad' to build a way of collaboratively working with patients to enhance their medication interest and ultimate follow-through. In a simplified format, the Choice Triad suggests that a patient will choose to take a medication if he or she holds the following three beliefs: !) the patient believes something is wrong, 2) the patient is motivated to use a medication to do something about it and 3) the patient is personally convinced that the pros outweigh the cons. If any of these beliefs are missing, nonadherence is likely. Shea, with remarkably keen insight shows exactly how patients navigate this triad. More important, and what truly makes this book unique, is his gifted ability to translate these principles into a series of over forty practical interviewing techniques which clinicians can immediately apply to their practices. Trust me, they work! Two of my favorite techniques are the 'Inquiry into Lost Dreams' and 'The Trap-Door Question.' Moreover, they can be easily taught and students' competency levels tested. The book should be a required standard in Introduction to Medicine or Introduction to Nursing courses. Students love it. Finally I just want to add that the sense of compassion and the sense of humor that is gently woven throughout the book makes it, in my opinion, one of the few modern classics on the physician and nurse/patient alliance. I can't put it any better than the author of the Foreword to the book, former Surgeon General C. Everett Koop who wrote 'This little book, in my opinion, is destined to fill a giant void in the training of all medical and nursing students, as well as becoming a classic read for experienced clinicians in search of the art of medicine. My advice is simple - read it.' Ditto for me.