Doctors 'spotty' at communicating drug info: Knowledge Driven Revolution

Doctors often prescribe medications without giving patients clear instructions about how to use them or offering them warnings about potential side-effects, researchers in California say.

Physicians gave full medication dosing directions for less than 60 per cent of medications, and informed patients about how to long to take the drug and side-effects about one-third of time, a recent study suggests.

"This study demonstrates spotty physician counselling about new medication prescriptions," Dr. Derjung Tarn of the University of California Los Angeles school of medicine and colleagues concluded in Monday's issue of the Archives of Internal Medicine

"Although physicians educated patients more about psychiatric and analgesic medications, the overall quality of communication was poor even for these medication types and could contribute to patient misunderstandings about how and why to take their new medication."

The study combined surveys of patients and physicians with an analysis of transcripts of audiotaped outpatient visits with 44 doctors, including family physicians, internists and cardiologists in 1999.

The transcripts were checked for five recommended directions to give patients:

* The name of the drug.
* The purpose for taking it.
* Duration of use.
* Side-effects.
* The number of tablets or sprays and the frequency or timing of ingestion.

Overall, doctors communicated an average of 3.1 of the five elements for the 242 new prescriptions that were written. The specific name was used for 74 per cent of new prescription, the purpose was explained 87 per cent of the time.

But side-effects were discussed only 35 per cent of the time, and instructions on the number of tablets to take and frequency or timing of doses were given 58 per cent of time.

Taking medications properly

The explanations were particularly poor for over-the-counter-medications, the researchers found.

Counselling about side-effects ranged from less than 15 per cent for antibiotics and skin medications to more than 60 per cent for psychiatric and cardiovascular drugs.

Patients who receive incomplete instructions may be less likely to take their medication properly, partly because they do not understand how to, the researchers concluded. For example, the patient may not realize that medications for chronic conditions need to be refilled, or that a full course of antibiotics needs to be taken.

They noted patients often get medication information from pharmacists, or other sources such as package inserts and nurses.

The study's authors noted societal and insurance changes have led to a shift in more information being included in conversations with patients since the data was collected.

Although the study's authors concluded "physicians often fail to communicate critical elements of medication use," they said more research is needed to see whether spending more time educating patients results in more appropriate use of the medications and better results.

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Doctors 'spotty' at communicating drug info: study