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What Your Doctor Isn't Telling You:
(Study: Doctors Don't Explain Rx Drugs)
Surveys and Transcripts Show Doctor-Patient Communication
Is Poor
Sept. 25, 2006 -- Americans are taking more
and more prescription drugs, but their doctors are doing
a poor job of communicating critical information about
the medications they prescribe, UCLA researchers report.
In a study that included surveys of both
doctors and patients, as well as taped transcripts of
actual office visits, the researchers concluded that all
too often doctors did not tell their patients why they
were prescribing specific medications.
They also frequently failed to tell them
about the potential adverse side effects of the drugs
they prescribed, or even the names of the drugs.
Poor communications between doctors and
their patients can lead to easily avoidable prescription
drug misuses, including drug overdoses and underuse.
"The message to patients is that they
should not be afraid to ask questions about the drugs
that are prescribed for them, and the message to physicians
is that patients need this information," researcher
Derjung M. Tarn, MD, PhD, tells WebMD.
Almost half of all Americans regularly take
at least one prescription drug, and half of older patients
take at least three or more, according to a report released
in 2004 by the National Center on Health Statistics.
Prescription drug misuse is a growing problem
in health care, which contributes to thousands of deaths
each year.
What You Need to Know
According to recommendations from the Agency
for Healthcare Research and Quality (AHRQ) --the federal
agency charged with improving health care quality -- all
patients should be given basic information about the drugs
that are prescribed for them, including:
The name of the medication, and whether the drug is
a trade medication or generic
Why the drug is being prescribed
How, when, and how long to take the medication
The drug's possible adverse side effects and what to
do if side effects occur
When to expect the medication to work, and how to tell
if it is working
Foods, herbal supplements, and other medications that
should be avoided while taking the drug
Doctor-Patient Interactions on Tape
In an effort to determine if this information was being
conveyed, Tarn and colleagues analyzed data from a study
of physician-patient interactions within two health care
systems in Sacramento, Calif.
The data included audiotaped recordings from 185 patient
visits to 16 family physicians, 18 internists, and 11
cardiologists between January and November of 1999.
The average age of the patients was 55, and three-quarters
of them had seen the doctor who prescribed the medication
more than once. Most patients were white and had some
college education.
While the doctors explained the purpose of the new medication
87% of the time, they described the medication by name
less often (74% of the time), and addressed possible adverse
side effects even less often (35% of the time).
Patients were told how long a medication should be taken
only 34% of the time, while just more than half were told
how many pills they should take (55%) and how often or
when to take the medication (58%).
'Okey Dokey'
One taped exchange, which the UCLA family practitioner
described as an extreme example of the tendency toward
"spotty communication" proceeded as follows:
Physician: "If I'm writing antibiotics, are you
allergic to penicillin?"
Patient: "No, I'm not allergic to anything."
Physician: "Okey dokey."
"That was actually the complete exchange,"
Tarn says. "There wasn't anything said after that
about the antibiotic."
Tarn and her UCLA colleagues hope to identify better
ways for doctors to communicate information about the
medications they prescribe.
"Efforts to promote better communication about new
prescriptions should not focus solely on improving the
quality of discussions without considering the tradeoffs
that may occur in time-compressed office visits,"
they wrote.
Pharmacists can help to educate patients, but Tarn says
there is currently too much variability in pharmacy care
to rely on this.
"There is currently a little bit of a disconnect
between doctors and pharmacists about how much information
is being provided by the other," she says.
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