Medications and doctor–patient communication

Abstract

BackgroundDoctor-patient communication is an important part of safe and effective medication use. There is a lot of evidence about good communication and recognition of several key features that are important when discussing medications. ObjectiveThe aim of this article is to provide evidence-based guidance for general practitioner (GP) communication with patients about starting, reviewing or stopping oral medication. DiscussionCommunication involves listening and asking, as well as imparting information. Creating space for discussions and encouraging patient involvement by asking questions are important. Doctors should deliver core content about why to take medication and actionable messages about how to do so. Regular summing-up and checks of patient understanding are important. Communicating benefits and harms can be facilitated by including numbers, if done carefully (include time periods, natural frequencies, absolute figures). Scheduling extra time, using written resources and enlisting support of pharmacist colleagues can assist with effective communication and help patients navigate the sometimesconfusing world of medications.DOCTOR-PATIENT COMMUNICATION about starting, continuing, changing or stopping medication can sometimes be difficult. Paying attention to communication is an important part of respect for patients as individuals, to foster the principles of patient-centred care and shared decision making, and to promote better medical outcomes. Poor communication between patients and their doctors is a well-established factor in medical errors and adverse events, including medication errors. [1][2][3][4][5][6] As a result, good communication between doctors and patients is now seen as a critical part of involving patients in healthcare and supporting safe and effective use and adherence to medications. 3,[6][7][8][9][10] Communication between general practitioners (GPs) and patients about medications encompasses many diverse approaches across different diseases and healthcare settings, often with very different purposes. 11 These include: providing information or education about medications to enable informed decision making, providing practical behavioural support for medication taking, reminding, skills training (eg correct measurement of liquid medication), counselling and medication review (eg optimisation of regimens, including deprescribing medications where required), and promoting involvement in communication and decision making. 8,[12][13][14][15][16] Good communication is also an important element of shared decision-making practice. It facilitates structured, inclusive discussion about medications and alternatives, and about patient values and priorities in relation to these options, in the context of healthcare management plans. 6,9,10,12,[17][18][19] Communication about medication use with patients (and their carers) has been a major focus of research for decades. 8,15,[20][21][22][23] A vast array of simple and complex approaches to communicating with people about their medications have b...

Complaint management system and patient satisfaction in grassroots hospitals

“…[10] For chronic disease patients, primary healthcare institutions offer regular follow-up and management services, helping stabilize their conditions and reducing the burden on advanced medical facilities. [11,12] In some countries’ healthcare systems, emphasizing the strengthening of primary healthcare services is a crucial strategy to enhance overall system efficiency and service levels. By improving the construction and management of primary healthcare institutions, they can better meet the basic medical needs of the community, improving the accessibility and quality of healthcare services.…”

A cross-sectional study on knowledge and behavior regarding medication usage among guardians of left-behind children: evidence from China

“…Firstly, Tools that can educate/ grade doctor-patient communication should be developed to constantly evaluate and adjust health-related behaviors among guardians of LBC during clinic visits. Several key features that are important when discussing medications have been summarized and an assessment framework for doctor-patient communication has been established which could address and alleviate many healthcare delivery inefficiencies [25,26]. Additionally, the government of China encourages medical staff from non-primary hospitals (higher-level hospitals) to provide Family Doctor Contract Service (FDCS) in community health service centers.…”

Communication about medication management during patient–physician consultations in primary care: a participant observation study

“… 28 This highlights the need of summarising and checking patient understanding. 29 Asking patients what medication they are using rather than reading the medication list aloud and ask them to confirm or deny using each medication would be an opportunity to assess patient’s understanding of their medications. Very few instances of shared decision making or patient participation in terms of the patient sharing their preference and priorities for treatment or management were observed during the consultations.…”

“…A study of patients discharged from an emergency department concluded that a majority of patients with poor understanding of their discharge instructions were not aware of their lacking understanding 28. This highlights the need of summarising and checking patient understanding 29. Asking patients what medication they are using rather than reading the medication list aloud and ask them to confirm or deny using each medication would be an opportunity to assess patient’s understanding of their medications.…”