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Physician Communication Spotty When Prescribing Medications

Physicians could do a much better job of communicating critical elements of medication use when they prescribe new drugs to their patients, a new UCLA study has found//.

The study, slated for publication in the Sept. 25 issue of the Archives of Internal Medicine, found that in too many instances, physicians did not address such things as the purpose of a medication, potential adverse side effects or even the names of drugs they were prescribing to their patients. Yet these gaps in the patients’ knowledge can lead to misuse, non-adherence, drug overdoses and under-doses and other potentially serious problems.

“Even though doctors prescribing new medications should tell patients the name of the drug, why the patient is getting it, how to take it and potential adverse effects, we’re just not seeing this happen consistently,” said Dr. Derjung M. Tarn, assistant clinical professor in the Department of Family Medicine at the David Geffen School of Medicine at UCLA and the study’s lead researcher.

The researchers analyzed data from the Physician Patient Communication Project, which examined audiotaped interactions between physicians and patients in two health care systems in Sacramento, Calif. These interactions involved 185 outpatient encounters with 16 family physicians, 18 internists and 11 cardiologists.

Patients in the study had a mean age of 55 and were evenly divided between male and female. Most were white and had some college education, and nearly all had health insurance. Three-quarters had made a prior visit to the physician who had prescribed new medications.

The researchers found that physicians mentioned the name of a new medication in 74 percent of the cases; explained the purpose of the medication 87 percent of the time; addressed adverse effects for 35 percent of the medications they prescribed; noted how long a medication should be taken in only 34 percent of the cases examined; instructed only 55 percent of patients as to the number of tablets they should take; and noted frequency or timing of doses in just 58 percent of the cases.

“This study demonstrates spotty physician counseling about new medication prescription,” the researchers wrote. “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.”

The Agency for Healthcare Research and Quality, in fact, recommends that patients specifically ask their physicians the name of the medication; if the medication is generic or trade; the medication’s purpose; how and when to take it and for how long; possible adverse side effects and how to respond if that occurs; what happens when the medication works and how to tell if it’s working, and what foods, other medications and herbal and dietary supplements to avoid when taking a particular drug.

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