Empower

This part of the structure is fundamental to understanding the patient’s motivation for taking the medicine. Some patients may show ambivalence about medicine taking, so use this opportunity to provide evidence to help them balance the risks and benefits for their situation. 

When talking about risks and benefits, it can be helpful to replace the term “risk” with “likelihood” or “chance” of side-effects, which have more neutral connotations. It is also important to acknowledge that no-one can be certain who will 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 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."

If, following an “empower” conversation, the patient decides they’d rather not take a medicine, you can still engage with them by asking:

• "What would you like to do to improve your health around [disease area]?"

If they don’t know what to do, you can make suggestions by offering options. For example, in hypertension:

• "I understand that you would rather not take medicines to treat high blood pressure at the moment. What do you know about other ways to lower blood pressure?"

If they have no ideas, you could add:

• "Some people find that increasing exercise is helpful. Others prefer to focus on changing their diet by reducing their salt, alcohol or caffeine intake. What would interest you/what would you like to try?"

If someone comes up with an idea you think is risky, ask them to think about it in a bit more detail. Often, when people delve into a subject, they realise they don’t know enough and want to find out more, or they work out for themselves that it isn’t a good idea.

If someone wants to do something you think could be harmful, you need to say so, but in a concerned rather than judgmental way, as you want them to return to talk about whatever they choose to do. So, to empower patients, help them to:

• Find their own reasons for wanting to take the medicines
• Come up with their own solutions to any issues they have
• Feel supported enough by you to return and discuss or know who to speak to next.