Sept. 25, 2006 -- Americans are taking more and more prescription drugs, but their doctors are doing a poor job of communicating critical information about the medications they prescribe, UCLA researchers report.
In a study that included surveys of both doctors and patients, as well as taped transcripts of actual office visits, the researchers concluded that all too often doctors did not tell their patients why they were prescribing specific medications.
They also frequently failed to tell them about the potential adverse side effects of the drugs they prescribed, or even the names of the drugs.
Poor communications between doctors and their patients can lead to easily avoidable prescription drug misuses, including drug overdoses and underuse.
"The message to patients is that they should not be afraid to ask questions about the drugs that are prescribed for them, and the message to physicians is that patients need this information," researcher Derjung M. Tarn, MD, PhD, tells WebMD.
Almost half of all Americans regularly take at least one prescription drug, and half of older patients take at least three or more, according to a report released in 2004 by the National Center on Health Statistics.
Prescription drug misuse is a growing problem in health care, which contributes to thousands of deaths each year.
What You Need to Know
According to recommendations from the Agency for Healthcare Research and Quality (AHRQ) --the federal agency charged with improving health care quality -- all patients should be given basic information about the drugs that are prescribed for them, including:
- The name of the medication, and whether the drug is a trade medication or generic
- Why the drug is being prescribed
- How, when, and how long to take the medication
- The drug's possible adverse side effects and what to do if side effects occur
- When to expect the medication to work, and how to tell if it is working
- Foods, herbal supplements, and other medications that should be avoided while taking the drug
Doctor-Patient Interactions on Tape
In an effort to determine if this information was being conveyed, Tarn and colleagues analyzed data from a study of physician-patient interactions within two health care systems in Sacramento, Calif.
The data included audiotaped recordings from 185 patient visits to 16 family physicians, 18 internists, and 11 cardiologists between January and November of 1999.
The average age of the patients was 55, and three-quarters of them had seen the doctor who prescribed the medication more than once. Most patients were white and had some college education.
While the doctors explained the purpose of the new medication 87% of the time, they described the medication by name less often (74% of the time), and addressed possible adverse side effects even less often (35% of the time).
Patients were told how long a medication should be taken only 34% of the time, while just more than half were told how many pills they should take (55%) and how often or when to take the medication (58%).
One taped exchange, which the UCLA family practitioner described as an extreme example of the tendency toward "spotty communication" proceeded as follows:
Physician: "If I'm writing antibiotics, are you allergic to penicillin?"
Patient: "No, I'm not allergic to anything."
Physician: "Okey dokey."
"That was actually the complete exchange," Tarn says. "There wasn't anything said after that about the antibiotic."
Tarn and her UCLA colleagues hope to identify better ways for doctors to communicate information about the medications they prescribe.
"Efforts to promote better communication about new prescriptions should not focus solely on improving the quality of discussions without considering the tradeoffs that may occur in time-compressed office visits," they wrote.
Pharmacists can help to educate patients, but Tarn says there is currently too much variability in pharmacy care to rely on this.
"There is currently a little bit of a disconnect between doctors and pharmacists about how much information is being provided by the other," she says.