Important Medication Information Often Not Communicated By Physicians

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Important Medication Information Often Not Communicated By Physicians

http://www.medicalnewstoday.com/medicalnews.php?newsid=52724

Physicians prescribing new medication often do not communicate to

patients important details, such as potential side effects, how long

or how often to take the drug or the specific name of the medication,

according to an article in the September 25 issue of Archives of

Internal Medicine, one of the JAMA/Archives journals.

Almost half of all Americans take at least one prescription drug, and

half of older adults take three or more, according to background

information in the article. Taking medications properly is essential

in ensuring their effectiveness. However, patients often do not

adhere to prescribed therapies, which can lead to worsening disease,

failure of the treatment, adverse effects, drug overdose, unnecessary

hospitalization and higher health care costs. " Patients who report

better general physician communication, better explanations about how

to take their medications and more medication information are more

adherent, " the authors write. " One-on-one educational interventions

can improve patient adherence and health outcomes. "

Derjung M. Tarn, M.D., Ph.D., of the Geffen School of Medicine,

University of California, Los Angeles, and colleagues assessed

communication by physicians prescribing new medications in 185

outpatient visits with 44 physicians in 1999. Patients were called

one to two days prior to their appointments at one of two health care

systems in Sacramento, Calif. Their encounters with the physicians

were then audiotaped and transcribed, and physicians identified those

at which new medications were prescribed. The researchers coded the

transcripts for the type of communication that occurred, based on

five key recommended elements: the name of the medication, the

purpose or justification for taking it, the duration of use, adverse

effects and the number of tablets or sprays plus the frequency or

timing of ingestion.

A total of 243 new medications were prescribed at visits monitored

during the study, including 46 cardiovascular medications; 42 ear,

nose and throat preparations; 35 analgesics (pain-relieving drugs);

35 antibiotics; 21 dermatologic creams; 21 psychiatric medications;

and 11 pulmonary medications. Overall, physicians communicated an

average of 3.1 of the five essential elements, indicating that 62

percent of the necessary information was conveyed. Physicians used

the specific name for 74 percent of new prescriptions, explained the

purpose for 87 percent and discussed adverse effects for 35 percent.

Thirty-four percent of the encounters included instructions on how

long to take the drug, 55 percent on the number of tablets to take

and 58 percent on the frequency or timing of dosing.

" This study demonstrates spotty physician counseling about new

medication prescriptions, " the authors write. " Although physicians

educated patients more about psychiatric and analgesic medications,

the overall quality of communication was poor even for these

medication types and could contribute to patient misunderstandings

about how and why to take their new medications. Physicians conveyed

full medication dosing directions for less than 60 percent of all

medications and informed patients about duration of intake and

adverse effects or adverse events only approximately one-third of the

time. "

Patients receiving incomplete instructions may be less likely to take

their medication properly, in part because they do not understand how

to do so, they conclude. However, patients often get medication

information from pharmacists and other sources, and there may be

trade-offs involved to asking physicians to provide more detailed

communication. " More research is needed to investigate how much time

physicians spend educating patients about new medications and whether

better communication is associated with more appropriate patient

medication use and health outcomes, " they write.

(Arch Intern Med. 2006;166:1855-1862.)