10.25376/hra.6724589.v1 Annalee Johnson-Kwochka Annalee Johnson-Kwochka Elizabeth Carpenter-Song Elizabeth Carpenter-Song Ida Griesemer Ida Griesemer Cara Nikolajski Cara Nikolajski Nancy Parrotta Nancy Parrotta Kim L. MacDonald-Wilson Kim L. MacDonald-Wilson Johnson-Kwochka_First Person Perspectives.pdf Health Research Alliance 2018 Qualitative interviews comparative effectiveness trial medication management community mental health center Decision Making 2018-06-29 18:34:42 Journal contribution https://hra.figshare.com/articles/journal_contribution/Johnson-Kwochka_First_Person_Perspectives_pdf/6724589 <p>Objective: Because of changes in health care, there is a</p> <p>greater focus on brief medication management visits as the</p> <p>primary method of providing psychiatric care in community</p> <p>mental health settings. Research on the first-person perspectives</p> <p>of service users and prescribers in these settings is</p> <p>limited. The objective of this study was to describe firstperson</p> <p>perspectives on medication management visits and</p> <p>the service user–prescriber relationship.</p> <p>Methods: Researchers conducted qualitative interviews as</p> <p>part of a larger comparative effectiveness trial at 15 community</p> <p>mental health centers, researchers interviewed service users</p> <p>(N=44) and prescribers (N=25) about their perspectives on the</p> <p>typical elements of a medication management visit and asked</p> <p>service users about their relationship with their prescriber.</p> <p>Results: Both service users and prescribers described</p> <p>medication management visits as very brief encounters</p> <p>focused on medication and symptoms. Most service users</p> <p>reflected on the service user–prescriber relationship in positive</p> <p>or neutral terms; they did not describe the development</p> <p>of a strong therapeutic relationship or a meaningful clinical</p> <p>encounter with prescribing clinicians.</p> <p>Conclusions: Service users described the service user–</p> <p>prescriber relationship and medication management visit</p> <p>as largely transactional. Despite the transactional nature of</p> <p>these encounters, most service users described relationships</p> <p>with prescribing clinicians in positive or neutral terms.</p> <p>Their satisfaction with the visit did not necessarily mean</p> <p>that they were receiving high-quality care. Satisfactionmay</p> <p>instead suggest service users’ disengagement from care.</p> <p>They may need more support to fully participate in their</p> <p>own care.</p>