|INTERVIEWING TIP OF THE MONTH
# 158 April 2013
Proactively Suggesting Medication Discontinuation if Needed
TISA Description of the Problem: In the Medication Interest Model (MIM), patient choice is the absolute cornerstone. In the following clinical interviewing tip, Cyd Q. Graft, a nurse practioner describes an interviewing technique, which I feel is very wise and that also nicely fits in with the MIM.
Tip: In order to emphasize patient choice I have found the following interviewing technique to be quite useful. After collaboratively deciding upon a specific medication, I say the following near the end of our appointment:
We have really covered the side effects carefully and hopefully you won't get many or any. But if for some reason, before our next appointment, you feel concerned about a side effect and can't reach me by phone, feel free to stop the medication immediately. You can give me a call afterwards or we can see if we can come up with a better fit at our next appointment.
I find that patients feel empowered and respected by such a statement. It both gives them a choice and also eliminates any fears that I might respond badly if they tell me they stopped the medication in our next appointment.
TISA Follow-up: Cyd's suggestion is a classic example of a well-thought-out clinical interviewing technique that fits the Medication Interest Model (MIM) perfectly. I actually think the technique can prevent a potential no-show at a next appointment that might occur if the patient was concerned that the nurse or physician or physician assistant was going to be displeased by their discontinuance. The technique communicates respect and recognition that the patient has the ultimate choice as to what medication is the best fit for him or her.
Tip provided by:
Cyd Q. Grafft
Pediatric & Child & Family Nurse Practioner
Black Hawk Grandy Mental Health Center
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