Spontaneous mental associations with the words "side effect": Implications for informed and shared decision making.
Sonya Izadi, Thorsten Pachur, Courtney Wheeler and 2 others
PMID 28583721WHAT IT FOUND
When women heard 'side effect', most first thought of harms, and many weighed risks or felt negative emotions.
The paper suggests medication counseling should ask which effects worry the patient and how they feel.
Key findings
0171% of women gave at least one spontaneous response about health problems caused by medication.
0253% gave at least one response about decision-relevant evaluations, such as weighing risks and benefits.
0331% gave at least one response reflecting negative emotions.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was homogeneous: 111 women were white and 77 had a Bachelor's or postgraduate degree. Formal inter-rater reliability was not assessed; codes were agreed by consensus. It was a secondary analysis of data collected for another side effect aversion study. 117 women had experienced a side effect, so the study could not compare people with and without side effect history. Participants who had experienced side effects rated only one severity response, so it is unclear which side effect they were rating if they had several. The study did not assess health literacy and did not exclude people who might know about side effects from healthcare or pharmaceutical work. Several demographic comparisons were made, so the small differences should be treated cautiously.
Declared interests
The authors declared no conflict of interest. The supplied text does not state a funding source.
The easy way to misread this
Do not conclude that patients reject beneficial treatment because they cannot calculate risk. The study only recorded what women spontaneously said when hearing the words 'side effect'; it did not test whether those associations caused treatment refusal or whether probability information changes decisions.