An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: The role of written and spoken communication

Abstract

Objective We tested the feasibility and efficacy of an electronic health record (EHR) strategy that automated the delivery of print medication information at the time of prescribing. Methods Patients (N = 141) receiving a new prescription at one internal medicine clinic were recruited into a 2-arm physician-randomized study. We leveraged an EHR platform to automatically deliver 1-page educational ‘MedSheets’ to patients after medical encounters. We also assessed if physicians counseled patients via patient self-report immediately following visits. Patients’ understanding was objectively measured via phone interview. Results 122 patients completed the trial. Most intervention patients (70%) reported receiving MedSheets. Patients reported physicians frequently counseled on indication and directions for use, but less often for risks. In multivariable analysis, written information (OR 2.78, 95% CI 1.10–7.04) and physician counseling (OR 2.95, 95% CI 1.26–6.91) were independently associated with patient understanding of risk information. Receiving both was most beneficial; 87% of those receiving counseling and MedSheets correctly recalled medication risks compared to 40% receiving neither. Conclusion An EHR can be a reliable means to deliver tangible, print medication education to patients, but cannot replace the salience of physician-patient communication. Practice implications Offering both written and spoken modalities produced a synergistic effect for informing patients.

Feasibility study for supporting medication adherence for adults with cystic fibrosis: mixed-methods process evaluation

“… 82 What may matter more than defining engagement is the correct assessment and tailoring of management to different psychosocial barriers. 69 83–91 Our study suggests that digital systems cannot replace, only complement, face-to-face interaction between health professionals and patients, 92–95 potentially creating a sense of ‘accountability’ consistent with control theory. 46 96 However, it is important to recognise that in the absence of objective adherence data, clinicians and patients will find it difficult to even begin to engage with behaviour change.…”

A randomised controlled trial of patient information leaflets as a medication counselling aid

“…Electronic medication dispensing could improve clinical use by providing a platform for automatic generation of written information and integration into the patient's health record. However, studies suggest benefit is greatest when written information is integrated into the verbal counselling process . This requires clinicians to find the tool useful themselves, and to perceive it is useful for their patients.…”

“…Studies highlight specific deficiencies in the communication of medicine name, indication for use, how to take the medicine and adverse effects . These deficiencies can be improved with the use of written information for patients . Written medicines information is most effective when combined with verbal counselling and is less effective when used alone as a ‘handout’ …”

“…These deficiencies can be improved with the use of written information for patients . Written medicines information is most effective when combined with verbal counselling and is less effective when used alone as a ‘handout’ …”

Review article: an analysis of safety profiles of treatments for diarrhoea‐predominant irritable bowel syndrome

“…)10,17,23,[31][32][33]40,42,44,48,50,78,81,87,108 and may be related to the primary endpoint of the studies and other methodologic considerations (patient population).Discussions about the negative aspects of therapeutic interventions are less important for some healthcare providers,109 who feel that sharing such information with patients could diminish treatment response (eg, impact adherence)109,110 and increase occurrence of perceived AEs,111 and also because safety data are often not as well and consistently publicised as efficacy data. However, discussion of potential treatment-related AEs has been considered by patients and some healthcare providers to be beneficial, as related communications may increase awareness and lessen the frequency of AEs 110,112,113.…”