‘What Matters to Me’ – a pharmacist’s view

• Written by: Joanne Brown — iSIMPATHY Project: Pharmacist
• Published: 4th July 2022

Joanne Brown member of the iSIMPATHY Project and Pharmacist reflecting on her experiences.

As a practising pharmacist in Northern Ireland for over 20 years, I always thought that I had a good understanding about patients’ needs and thoughts. We have known for years about how important shared decision making is, how essential it is to include the patient in decisions about them. The Royal Pharmaceutical Society’s Medicine Optimisation Framework (2015) has four principles, the first of which is to ‘aim to understand the patient’s experience’. I always thought I was good at this. I was friendly and approachable, provided lots of information about medicines and was always happy to answer any questions. I read the notes, had a list of medicines and had a conversation with the patient. Surely this was enough to tell me everything I needed to know? Surely I knew what mattered to the patient?

Since January 2021, I have been working on the iSIMPATHY project (implementing Stimulating Innovation in the Management of Polypharmacy and Adherence Through the Years) (this link will take you away from our website). This project is delivering medication reviews to patients in Scotland, Ireland and Northern Ireland and allows more time to have detailed conversations with patients. During the review I follow a structured 7-step process which focuses on what matters to the patient and includes issues such as consideration of medications that may no longer be needed, or may be causing problems or may be difficult for the patient to take. The first question in the review is ‘what matters to you?’

My confidence that I knew what mattered to the patient was overestimated. Yes, I knew something about the patient’s thoughts, and yes, I was a good pharmacist and made good interventions. I was understanding the patients’ experience, but did I actually know what mattered to them?

Since January 2021 I have been asking ‘what matters to you?’ These conversations have been happy, sad, funny, painful, interesting and intriguing, but, always valuable and important. They have led to us (the patient and I) making changes to medicines together, discussing issues that had been undocumented, talking about lifestyle changes and motivating change to unhealthy choices, finding out what the patient actually wants to do with their medicines and whether they think they are worth taking. These conversations have produced outcomes big and small. For example arranging for toenails to be cut, buying chocolate from the hospital shop, stopping unwanted and unnecessary medicines, requesting lab tests, contacting family members, being the first person a patient has talked to about their suicidal feelings. I have valued each and every conversation.

Having these discussions has allowed for more changes and interventions and better outcomes for patients. Patients have felt fully engaged in the conversations and the actions about their health and wellbeing and patient feedback has been very positive.

Asking the question ‘what matters to you?’ has also highlighted to me that some patients are not used to being asked this. Some patients have said ‘what do you mean?’ or ‘no-one has ever asked me this before’. I am converted to the ‘what matters to you’ movement as I have seen the benefits of asking this question. I am looking forward to continuing these conversations and disseminating the positives of asking ‘what matters to you?’ to colleagues.

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