Tuesday, September 26, 2006

Study: Doctors not giving patients full prescription info

Scripps Howard News Service

Doctors tell patients how they should take a new drug only about half the time, often don't even mention the name of the drug being prescribed and fail to discuss possible side effects two-thirds of the time, according to a new study.

Researchers at the University of California-Los Angeles evaluated how 44 physicians discussed new prescriptions in nearly 200 tape-recorded encounters at two health-care systems in Sacramento.

Doctors were rated on five essential points: the drug's name; the reason for taking it; the duration of use; the number of doses and their timing, and common side effects. The researchers found that, on average, the doctors covered about 62 percent of the information.

"This study demonstrates spotty physician counseling about new medication prescriptions, when we know that patients who have better physician communication, better explanations about how to take their medications and more medication information are more adherent," said Dr. Derjung Tarn, a family-medicine instructor and researcher at UCLA's David Geffen School of Medicine and lead author of the report. It was published Monday in the Archives of Internal Medicine.

Government surveys show that almost half of all Americans take at least one prescription drug on a regular basis, and that half of the elderly take three or more drugs regularly.

During the study, 243 new medications were prescribed to 185 patients _ most commonly, heart and blood-pressure drugs; ear, nose and throat preparations; pain relievers, and antibiotics.

The researchers studied transcripts of each session and checked off each type of communication that took place. The recordings took place with the patients' consent.

Researchers found that physicians used the specific name of the new drug just 74 percent of the time and explained the purpose of the drug 87 percent of the time. But the researchers also found the doctors discussed the number of tablets to take in just 55 percent of the encounters, and went over possible adverse effects just 35 percent of the time.

"Although physicians educated patients more about psychiatric and analgesic medications, the overall quality of communication was poor even for those medication types, and could contribute to patient misunderstandings," the researchers said in the study.

According to a report issued by the national Institute of Medicine earlier this year, at least 1.5 million Americans are sickened, injured or killed annually due to errors in prescribing, dispensing and taking medications.

Much of the focus on these errors has been on patients getting the wrong drug or a wrong dose due to mistakes made by doctors and pharmacists. But experts also point out that overdosing or underdosing by patients who don't receive or follow directions is equally dangerous.

Even if a patient doesn't leave the doctor's office with a written script in this era of increasing electronic prescribing, studies suggest that giving him or her basic information about the medication adds some assurance that the right medicine will be taken the right way.

Tarn and her colleagues said that it's unclear just how important it is that doctors tell patients about new drugs, since people do get information from pharmacists and other sources, and this study didn't look at what happened after patients left the doctor's office.

More research needs to be done to prove whether better communication by doctors about medicines actually results in proper use of the drugs and improved health outcomes, they wrote.

On the Net: http://archinte.ama-assn.org

(Contact Lee Bowman at BowmanL(at)SHNS.com. Distributed by Scripps Howard News Service, http://www.shns.com)