Physician, Hear Thyself

To find out, Tarn, an assistant clinical professor in the Department of Family Medicine at the David Geffen School of Medicine at UCLA, analyzed data from the Physician Patient Communication Project, which examined audiotaped interactions between physicians and patients in two health-care systems in Sacramento. Publishing in the peer-reviewed Archives of Internal Medicine, she and her colleagues reported that in too many instances, physicians failed to provide the most basic facts about the drugs that they were prescribing or recommending their patients buy over the counter. "The study demonstrates spotty physician counseling about new medication prescription," the researchers wrote, which "could contribute to patient misunderstandings about how and why to take their new medications."

The doctors mentioned the medication's name 74 percent of the time, explained its purpose 87 percent, addressed adverse effects for 35 percent of the medications prescribed, noted how long the medications should be taken 34 percent of the time, instructed 55 percent of the patients as to the number of tablets they should take, and noted the frequency or timing of doses in just 58 percent of the cases.

Physicians were better at providing details when prescribing psychiatric and pain medications, which have the potential for serious adverse effects or reactions. But even there, Tarn and colleagues concluded, the overall quality of those communications was poor.

The percentage of doctors counseling their patients about adverse effects ranged from less than 15 percent of newly prescribed dermatologic and antibiotic drugs to more than 60 percent of new prescriptions for psychiatric and cardiovascular medications. Education about the length that a prescription regimen should be followed ranged from 17 percent for cardiovascular drugs to 54 percent for antibiotics.

Drawing the conclusion that lack of information on prescribed drugs could lead to their misuse or worse doesn't require a major leap. Not being aware of potential adverse effects, for example, could make patients less likely to report a problem should one occur. And not knowing the name of a drug can affect patients' ability to communicate important information in other settings, whether they're seeing other doctors or visiting an emergency room. This is a particular problem for patients with poor English fluency, Tarn notes.

Published Jan 1, 2007 8:00 AM