Science + Technology

Physician Communication Is Spotty at Best When it Comes to Prescribing New Medications, UCLA Study Finds


Physicians could doa much better job of communicating critical elements of medication use whenthey prescribe new drugs to their patients, a new UCLA study has found.

The study, slatedfor publication in the Sept. 25 issue of the Archives of Internal Medicine,found that in too many instances, physicians did not address such things as thepurpose of a medication, potential adverse side effects or even the names ofdrugs they were prescribing to their patients. Yet these gaps in the patients'knowledge can lead to misuse, non-adherence, drug overdoses and under-doses andother potentially serious problems.

"Even though doctors prescribing new medications should tellpatients the name of the drug, why the patient is getting it, how to take itand potential adverse effects, we're just not seeing this happen consistently," said Dr. DerjungM. Tarn, assistant clinical professor in the Department of Family Medicine atthe David Geffen School of Medicine at UCLA and the study's lead researcher.

The researchers analyzeddata from the Physician Patient Communication Project, which examined audiotaped interactions between physicians and patients intwo health care systems in Sacramento, Calif. These interactionsinvolved 185 outpatient encounters with 16 family physicians, 18 internists and11 cardiologists.

Patients in thestudy had a mean age of 55 and were evenly divided between male and female.Most were white and had some college education, and nearly all had healthinsurance. Three-quarters had made a prior visit to the physician who hadprescribed new medications.

The researchersfound that physicians mentioned the name of a new medication in 74 percent ofthe cases; explained the purpose of the medication 87 percent of the time;addressed adverse effects for 35 percent of the medications they prescribed;noted how long a medication should be taken in only 34 percent of the casesexamined; instructed only 55 percent of patients as to the number of tabletsthey should take; and noted frequency or timing of doses in just 58 percent ofthe cases.

"This studydemonstrates spotty physician counseling about new medication prescription,"the researchers wrote. "Although physicians educated patients more aboutpsychiatric and analgesic medications, the overall quality of communication waspoor even for these medication types and could contribute to patientmisunderstandings about how and why to take their new medications."

The Agency forHealthcare Research and Quality, in fact, recommends that patients specificallyask their physicians the name of the medication; if the medication is genericor trade; the medication's purpose; how and when to take it and for how long;possible adverse side effects and how to respond if that occurs; what happenswhen the medication works and how to tell if it's working, and what foods,other medications and herbal and dietary supplements to avoid when taking aparticular drug.

Other researchers onthis study in addition to Tarn are JohnHeritage, Ron. D. Hays and Neil Wenger, all of UCLA, and Debora A. Paterniti and Richard L. Kravitzof UC Davis.

Funding the studywere the Robert Wood Johnson Foundation, a National Research Service Award fromthe Health Resources Services Administration, the UCLA/DREW Project EXPORT, theNational Institutes of Health, the National Center on Minority Health &Health Disparities, the UCLA Center for Health Improvement in MinorityElders/Resource Centers for Minority Aging Research, the National Institute onAging and the National Institute of Mental Health.



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