How much time does it take to prescribe a new medication?

Abstract

Objective-To measure the length of time spent discussing all aspects of new prescriptions and guideline-recommended aspects of counseling, and to evaluate factors associated with duration of discussion.Methods-We analyzed tape recordings in which 181 patients received 234 new medication prescriptions from 16 family physicians, 18 internists, and 11 cardiologists in 2 healthcare systems in Sacramento, California between January and November 1999.Results-Of the mean total visit time of 15.9 minutes (SD=434 seconds), a mean of 26 seconds (SD=28 seconds) was allocated to guideline-recommended components and a mean of 23 seconds (SD=25 seconds) was allocated to discussion of all other aspects of new prescription medications. The majority of time spent discussing individual new prescriptions was dedicated to: medication purpose or justification, directions and duration of use, and side effects. On average, more complete discussion of these components was associated with more time. More time was spent talking about guideline-recommended information if patients were in better health, if there was a third party in the room, and if the medication belonged to a psychiatric, compared to an ear, nose, throat medication class. Less time was spent discussing over-the-counter medications and those prescribed to patients with a previous visit to the physician.Conclusion-Higher quality information transmission between physicians and patients about new medications requires more time, and may be difficult to achieve in short office visits.Practice Implications-Time-compressed office visits may need to be redesigned to promote improved provider-patient communication about new medications.

Patients’ and health professionals’ views and experiences of atrial fibrillation and oral-anticoagulant therapy: A qualitative meta-synthesis

“…Deveugeule et al [34] found that the mean length of consultations in the UK was almost 10 minutes. Similar to the findings of this synthesis, the literature suggests that this is not enough time to establish rapport with the patient, transmit information, and address the patient's needs [35,36], which could have an effect on patient adherence to treatment. Developments in health psychology have resulted in several theoretical models for understanding variations in adherence to treatment.…”

Understanding patients’ perspective of statin therapy: can we design a better approach to the management of dyslipidaemia? A literature review

“…Gialamas et al (25) likewise found that only 62% of patients fully understood why they needed to take cholesterol-lowering medications. This lack of patient understanding regarding the benefits of cholesterol-lowering medications was also highlighted by Lytsy and Westerling, (26) who observed that some patients appeared to have difficulty understanding the preventive effect of statins.…”

“…(27) Patients' lack of understanding and knowledge about lipid-lowering drugs may translate to poor patient satisfaction and consequently, lower medication adherence. (26) Another important barrier to the use of statins is the side effects associated with it. A serious, but rare, side effect is rhabdomyolysis.…”

Physicians' Practice of Dispensing Medicines

“…Studies from different contexts have shown that doing this well may improve patient outcomes, such as a reduced rate of admission with a serious bleed for patients on warfarin. 36,37 Despite this, drugs are prescribed with inadequate discussion, 38,39 with this likely contributing to the low adherence rates achieved by many patients. [40][41][42] The application of the prescription charge in emergency departments in England is variable, and it is not surprising that physicians, who may have trained and worked in several hospitals, have varying approaches to this often controversial topic.…”