Which Providers Should Communicate Which Critical Information About a New Medication? Patient, Pharmacist, and Physician Perspectives

Journal of the American Geriatrics Society - Tập 57 Số 3 - Trang 462-469 - 2009
Derjung M. Tarn1, Debora A. Paterniti1, Bradley R. Williams1, Camille Cipri1, Neil S. Wenger1
1University of Southern California, Los Angeles, United States

Tóm tắt

OBJECTIVES: To investigate older patient, pharmacist, and physician perspectives about what information is essential to impart to patients receiving new medication prescriptions and who should provide the information.DESIGN: Qualitative focus group discussions.SETTINGS: Senior centers, retail pharmacies, and primary care physician offices.PARTICIPANTS: Forty‐two patients aged 65 and older, 13 pharmacists, and 17 physicians participated in eight focus groups.MEASUREMENT: Qualitative analysis of transcribed focus group interviews and consensus through iterative review by multidisciplinary auditors.RESULTS: Patient, pharmacist, and physician groups all affirmed the importance of discussing medication directions and side effects and said that physicians should educate about side effects and that pharmacists could adequately counsel about certain important issues. However, there was substantial disagreement between groups about which provider could communicate which critical elements of medication‐related information. Some pharmacists felt that they were best equipped to discuss medication‐related issues but acknowledged that many patients want physicians to do this. Physicians tended to believe that they should provide most new‐medication education for patients. Patients had mixed preferences. Patients aged 80 and older listed fewer critical topics of discussion than younger patients.CONCLUSION: Patients, pharmacists, and physicians have incongruent beliefs about who should provide essential medication‐related information. Differing expectations could lead to overlapping, inefficient efforts that result in communication deficiencies when patients receive a new medication. Collaborative efforts to ensure that patients receive complete information about new medications could be explored.

Từ khóa


Tài liệu tham khảo

Wilson IB, 2007, Physician‐patient communication about prescription medication nonadherence, A 50-state study of America's seniors, 22, 6

Safran DG, 2005, Prescription drug coverage and seniors, Findings from a 2003 national survey, W5‐152

Malhotra S, 2001, Drug related medical emergencies in the elderly, Role of adverse drug reactions and non-compliance, 77, 703

Taylor SA, 2002, Causes of non‐compliance with drug regimens in glaucoma patients, A qualitative study, 18, 401

10.1111/j.1525-1497.2006.00329.x

10.1016/S0167-4943(96)00722-4

10.1097/00005650-198807000-00002

Bull SA, 2002, Discontinuation of use and switching of antidepressants, Influence of patient-physician communication, 288, 1403

10.2105/AJPH.66.9.847

SvarstadBL.The Doctor‐Patient Encounter: An Observational Study of Communication and Outcome. Sociology PhD Dissertation. University of Wisconsin 1974.

10.1111/j.1369-7625.2004.00280.x

Nair K, 2002, What patients want to know about their medications. Focus group study of patient and clinician perspectives, Can Fam Physician, 48, 104

Berry DC, 1995, What do patients want to know, An empirical approach to explanation generation and validation, 8, 419

Berry DC, 1997, What do patients want to know about their medicines, and what do doctors want to tell them?, A comparative study, 12, 467

10.1177/104973299129122243

10.1001/archinte.1994.00420230150018

Howland JS, 1990, Does patient education cause side effects? A controlled trial, J Fam Pract, 31, 62

10.1192/bjp.122.4.461

Myers ED, 1976, The effect of forewarning on the occurrence of side‐effects and discontinuance of medication in patients on dothiepin, J Int Med Res, 4, 237, 10.1177/030006057600400405

10.1007/BF00846163

10.1111/j.1532-5415.2007.01345.x

10.7326/0003-4819-135-8_Part_2-200110161-00009

Questions are the Answer: Getting a Prescription. Agency for Healthcare Research and Quality Rockville MD [on‐line]. Available athttp://www.ahrq.gov/questionsaretheanswer/level3col_1.asp?nav=3colNav05&content=05_0_prescriptionAccessed October 20 2008.

Medicines: Use Them Safely. National Institute on Aging. April 2007. Bethesda MD [on‐line]. Available athttp://www.niapublications.org/agepages/medicine.aspAccessed October 20 2008.

NIH Senior Health: Talking with Your Doctor‐Asking Questions‐Asking About Your Medications. National Institutes of Health July 26 2007 [on‐line]. Available athttp://nihseniorhealth.gov/talkingwithyourdoctor/askingaboutyourmedications/01.htmlAccessed October 20 2008.

10.1016/j.pec.2006.02.003

10.1001/archinte.166.17.1855

10.1016/0738-3991(85)90003-5

10.5694/j.1326-5377.1987.tb133509.x

Makoul G, 1995, Health promotion in primary care, Physician-patient communication and decision making about prescription medications, 41, 1241

Law AV, 2003, Unmet needs in the medication use process, Perceptions of physicians, pharmacists, and patients, 43, 394

10.1016/S0738-3991(97)00033-5

10.1093/her/cym048

Svarstad BL, 2004, Patient counseling provided in community pharmacies, Effects of state regulation, pharmacist age, and busyness, 44, 22

10.1007/s11096-007-9155-6

Borenstein JE, 2003, Physician‐pharmacist comanagement of hypertension, A randomized, comparative trial, 23, 209

10.1136/bmj.323.7325.1340

Morgan DL, 1998, Focus Group Kit

Strauss AL, 1998, Basics of Qualitative Research Techniques and Procedures for Developing Grounded Theory

Denzin NK, 2000, Handbook of Qualitative Research

Huang SW., 1998, The Omnibus Reconciliation Act of 1990, Redefining pharmacists' legal responsibilities, 24, 417

Smith WE, 2002, Physicians' expectations of pharmacists, Am J Health Syst Pharm, 59, 50, 10.1093/ajhp/59.1.50

10.1001/archinte.161.5.706