The practice of prescribing: Discovering differences in what we tell patients about prescription medications

Childress, Marc A; Ledford, Christopher C.; Mundy, Heather D.

doi:10.1016/j.pec.2013.10.002

Cited by 4 publications

(3 citation statements)

References 48 publications

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“…Prior studies found similar, if not lower, rates of physicians counseling patients on side effects and risks compared to other medication attributes in both audiotaped encounters [10] and when counseling was self-reported by patients [11,37]. Evidence has reported upon clinicians’ reservations to discuss associated medication side effects as it may potentially negatively impact adherence [16,38].…”

Section: Discussionmentioning

confidence: 97%

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

Curtis

Mullen

Russell

et al. 2016

Patient Education and Counseling

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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.

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Section: Discussionmentioning

confidence: 97%

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

Curtis

Mullen

Russell

et al. 2016

Patient Education and Counseling

View full text Add to dashboard Cite

show abstract

“…20 T A B L E 2 presents the individual items and representative determinants. The index ranged from 6 to 30, where high scores indicated positive discussion.…”

Section: Patient-level Evaluationmentioning

confidence: 99%

Refining the Practice of Prescribing: Teaching Physician Learners How to Talk to Patients About a New Prescription

Childress¹,

Ledford²,

Mundy³

2014

Journal of Graduate Medical Education

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Background Clinician counseling about medication can improve patient understanding and adherence. This study developed a teaching session for physician learners about medication prescribing and communication, with evaluation at the physician and patient levels. Objective We analyzed whether patients would perceive and report more comprehensive clinician presentation of medication information when receiving prescriptions from their physician in the intervention clinic. Methods We conducted a single site, prospective intervention study that included lectures, role play, an objective standardized clinical examination (OSCE), and reminders displayed in patient care areas. For physician-level assessment, pretests and posttests included a written case presentation and a OSCE. For patient-level assessment, we used a cross-sectional observational design that included study of patient recall information, and assessment of patient satisfaction before and after intervention. Results Twenty-seven family medicine residents and sports medicine fellows participated in the teaching session, focused on presenting patients the reasons, risks, and regimen of prescribed medication. In written testing, learners presented significantly more comprehensive information in posttests. In the OSCE (n = 14), all learners presented risks and regimen information. However, patient-level assessment showed no significant difference between before and after intervention. Notably, the covariates patient activation and satisfaction with communication both had a significant association with patient recall information. Conclusions Our intervention improved learner presentation of medication information. However, patient recall of the information conveyed did not change. Although physician training did not have a positive effect on patient recall, patient activation emerged as a critical influence of patients' perceptions of medication discussions.

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“…There is a report on qualitative research from the viewpoint of risk evaluation in intensive care medicine [8]. In addition, the study says that the emphasis on appropriate medication counseling should not be limited to medications available only by prescription [9]. In Japan, we think there is still the specificity of ''difference in recognition'' and ''difference in information'' between patients and medical practitioners.…”

Section: Introductionmentioning

confidence: 99%

Patient’s recognition level of medical terms as estimated by pharmacists

Yoshida

2014

Environ Health Prev Med

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Objectives The role of pharmacists in the healthcare settings is expanding and pharmacists are expected to counsel patients and/or caregivers regarding the appropriate use of a drug. However, we believe that communication between healthcare providers and patients may be limited by overestimation of patients' recognition level of medical terms by providers. The purpose of this study was to clarify patients' recognition level of medical terms, mainly related to drugs, as estimated by pharmacists to contribute to improving risk communication in the medical care field. Methods A total of 211 medical doctors and 212 pharmacists were surveyed. Differences between patients' recognition level of medical terms as estimated by medical doctors and pharmacists were assessed. In total, 90 medical terms were evaluated, including 57 medical terms from the National Institute for Japanese Language and an additional 33 medical terms. Results Patient's recognition level of the selected medical terms as estimated by pharmacists was higher than that estimated by medical doctors. Conclusions Compared with medical doctors, pharmacists tend to overestimate patients' recognition level of medical terms. Therefore, pharmacists need to take greater care to ensure that their patients fully understand the risks and benefits of the drugs.

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The practice of prescribing: Discovering differences in what we tell patients about prescription medications

Cited by 4 publications

References 48 publications

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

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

Refining the Practice of Prescribing: Teaching Physician Learners How to Talk to Patients About a New Prescription

Patient’s recognition level of medical terms as estimated by pharmacists

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