Physician communication to patients regarding medications

Scherwitz, Larry; Hennrikus, Deborah J.; Yusim, Solomon; Lester, Jerry W.; Vallbona, Carlos

doi:10.1016/0738-3991(85)90003-5

Cited by 45 publications

(30 citation statements)

References 4 publications

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“…Previous research has shown that physicians give more medication-related instructions than justification for use or motivational statements and rarely ask whether the patient is taking the medication. 27 More recent data indicate that, in medical consultations during which a new medicine was prescribed or dosing changes were made to an existing medicine, 61% of the time at least 1 medication was not specifically named, 21% of the time no dosing information was provided, and 53% of the time no information about side effects was provided. 17 Moreover, patients seem reluctant to volunteer information about medication preferences or overthe-counter drug use, and physicians do not seem to understand patient views on medication.…”

Section: Discussionmentioning

confidence: 99%

Caregiver-Physician Medication Concordance and Undertreatment of Asthma Among Inner-City Children

et al. 2003

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ABSTRACT. Objective. To assess the extent to which caregivers and their child's physician agree about the prescribed asthma medication regimen and evaluate factors associated with medication concordance.Methods. A cross-sectional, descriptive survey was administered to 318 caregivers of inner-city children with asthma, aged 5 to 12 years, and their caregiver-identified primary care physician at elementary schools and participants' homes. Concordance between caregiver-and physician-reported controller medication prescription was measured.Results. Only 42% of physicians and 32% of caregivers reported a controller medication prescription (78% agreement, ‫؍‬ 0.54; 95% confidence interval: 0.45-0.63) despite that 73% of the children were rated by their caregiver as currently experiencing persistent asthma symptoms. When the physician reported a controller prescription, 38% of the caregivers denied use of a controller. Having a course of oral steroids in the past year ( 2 ‫؍‬ 9.85) and positive caregiver beliefs toward asthma care ( 2 ‫؍‬ 18.40) were associated with caregiver-physician concordance. Multivariate analysis found that when caregivers had high Asthma Beliefs Scale summary scores versus low scores, they were almost 10 times as likely to be concordant with the physician (odds ratio: 9.76; 95% confidence interval: 2.85-33.46).Conclusions. Our data support previous reports of physician underprescribing of controller medication among inner-city children. However, even when prescribed by a physician, more than one third of caregivers did not report a controller prescription, and this discordance was related to caregivers' beliefs about treatment. Efforts to improve physician adherence to asthma guidelines will not result in proper treatment unless caregiver-physician communication about asthma therapy is improved. Pediatrics 2003;111:e214 -e220. URL: http://www.pediatrics.org/cgi/content/full/111/3/e214; attitudes, beliefs, adherence, compliance.

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Section: Discussionmentioning

confidence: 99%

Caregiver-Physician Medication Concordance and Undertreatment of Asthma Among Inner-City Children

et al. 2003

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“…These codes were based on previous literature (14)(15)(16) and clinical experience. The coders used analytic induction to split, merge, and adjust the codes until they were mutually exclusive, yet still described every conversational element concerning new prescriptions.…”

Section: Development Of Codes Describing New Medication Discussionmentioning

confidence: 99%

“…Similarly, guidelines suggest that physicians educate older patients receiving new prescriptions about the medication's purpose, side effects, and directions for use (9,10). However, physicians offer only spotty counseling about these topics (11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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

Tarn

Paterniti

Kravitz

et al. 2008

Patient Education and Counseling

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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.

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“…16,35 ( Table 1) We also postulated that the type of chief complaint at the index visit (acute, chronic, or health maintenance) might affect medication counseling; therefore, we also included this covariate in our analyses.…”

Section: Covariatesmentioning

confidence: 99%

“…We selected covariates that published evidence had suggested were associated with medication counseling by physicians, including gender, 17 age, 17,34 race/ethnicity, 16 educational level, 17 continuity of care by the same or a different physician, 35 number of medications, 16 and the type of medications (new or continued). 16,35 ( Table 1) We also postulated that the type of chief complaint at the index visit (acute, chronic, or health maintenance) might affect medication counseling; therefore, we also included this covariate in our analyses.…”

Section: Covariatesmentioning

confidence: 99%

Cross-Sectional Comparison of Electronic and Paper Medical Records on Medication Counseling in Primary Care Clinics: A Southern Primary-care Urban Research Network (SPUR-Net) Study

Kuo

Mullen

McQueen

et al. 2007

The Journal of the American Board of Family Medicine

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Introduction: This study compared the frequency of oral counseling and written information by primary care physicians at paper medical record (PMR) clinics and electronic medical record (EMR) clinics, and assessed relationships between medication counseling and medication outcomes (knowledge, questions, reported adherence and side effects, and medication fill).Methods: A cross-sectional study with two convenience samples of English-speaking adult patients receiving >1 prescription at the primary care index visit was conducted in two PMR clinics, with 184 (48% response) patients seen by one of 22 physicians, and in two EMR clinics, with 249 (37% response) patients seen by one of 25 physicians. Data were from medical record reviews of the index visit and 2-week post-visit telephone interviews.Results

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Physician communication to patients regarding medications

Cited by 45 publications

References 4 publications

Caregiver-Physician Medication Concordance and Undertreatment of Asthma Among Inner-City Children

Caregiver-Physician Medication Concordance and Undertreatment of Asthma Among Inner-City Children

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

Cross-Sectional Comparison of Electronic and Paper Medical Records on Medication Counseling in Primary Care Clinics: A Southern Primary-care Urban Research Network (SPUR-Net) Study

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