OT: Study: Doctors Don't Explain Rx Drugs (WELL A BIG DUH)..

Discussion in 'Fibromyalgia Main Forum' started by kjfms, Sep 26, 2006.

  1. kjfms

    kjfms Member

    I encourage everyone to write down the six questions below and make sure you ask you physicians each one when receiving medication -- it is crucial not only to our treatments but to our well being as patients.


    OK I will shut up here is the study: :)


    Original page:
    http://www.webmd.com/content/Article/127/116830.htm

    Study: Doctors Don't Explain Rx Drugs

    Surveys and Transcripts Show Doctor-Patient Communication Is Poor

    By Salynn Boyles


    WebMD Medical News

    Reviewed By Louise Chang, MD
    on Monday, September 25, 2006

    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:

    1. The name of the medication, and whether the drug is a trade medication or generic.

    2. Why the drug is being prescribed.

    3. How, when, and how long to take the medication.

    4. The drug's possible adverse side effects and what to do if side effects occur

    5. When to expect the medication to work, and how to tell if it is working.

    6. 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%).

    'Okey Dokey'

    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.


    --------------------------------------------------------------------------------

    SOURCES: Tarn, D.M. Archives of Internal Medicine, Sept. 25, 2006; vol 166: pp 1855-1862. Derjung M. Tarn, MD, PhD, assistant professor of medicine, department of family medicine, David Geffen School of Medicine, University of California, Los Angeles.



    Thanks for reading,

    Karen :)

    [This Message was Edited on 09/27/2006]
  2. rosemarie

    rosemarie Member

    I understand what you saying about Doctors not explaining medications to us. The side offects , how they can affect us and do they have long term side effects that can be harmful. I have never had a MD tell me any thing about the meds I take I have had to ask my pharmist to find out what I am taking and waht are the good and bad points about it.

    My Mom on the other hand was put on pregisnosone but never ever told that the side effects of it are that it can reduce your immune system, .IT makes you more suspectable to any infections and to her this is really upsetting.


    All she was told was that she would be feeling less pain in a few days after taking oral preginsone{SP}. Now it is sevreal years later and she her immune system is not working as well as it should be.


    She is so prone to skin infections. This summer she has had 2 bouts of cellulitis in 2 months. And they found a huge pocket of infection in her left arm. That was found after she had been on really strong IV antibitoics for 5 days and still she had to have this spot drained.

    After she fell a few weeks ago she was told my a doctor that she should be cutting down on the pregennsone and when she asked why as it helped her back pain he said it is ruining you immune system. Why was she not told this when she was first given this?

    I have found that most doctors who have elderly patients they tend to not explain to them all of the side effects that the medications they take cause cause more problems the good that they do. My Mom is in her late 70's and when she was put on pregisnone {SP} SEvreal years ago all the instructions and information she got was that it would make her feel better soon. But not that if this drug was taken long term it can and will do damage to theier immune system. Which in my Mom's case it has done alot of harm to her body .HEr immune system doesn ot wrok like it should . And she needs it to help with the pain of the rehumitisim.

    I to wonder why it is that our Md's don't give us all the information that we need to be well informed about our medications.

    Thank you for bringing this to our attention.
    It is really some thing that we all need to know about and to ask our doctors what the long term is doing to be when We really do need to understand what our meds are doing to us.
    Rosemarie
  3. kjfms

    kjfms Member

    Thank you both for reading. I thought it was a very important article/study.

    I think a lot of stems from the fact that physicians are so busy and they just forget [some not all].

    I use Medscape's interaction drug checker which is really good. I can enter my entire prescription regimen and find any interactions.

    Hayley you sound like me I usually get the odd side effects that not a lot of people get...LOL

    Rosemarie I am so sorry you mother had to go through all of that because of Prednisone it can be a nasty drug. My sister took it for a long time before some of the newer steroids came out she has Crohn's disease.

    Thanks,

    Karen :)
  4. kjfms

    kjfms Member

    LOL...well I just couldn't help myself -- they actually needed to do a study?

    You sound as anal as I am...LOL (In a good way)

    I agree you can never know too much about any Rx drug you are prescribed.

    Thanks I needed a laugh,

    Karen :)
  5. suzetal

    suzetal New Member

    I believe it is my responsibility to ask questions of whom ever is prescribing the medication.

    Even at the ER.I had gone due to a major fall.The doctor there wrote a script with out asking me one ? .I had to inform him of the meds I was already on.

    His response oops cant give you this one and wrote one that would go with what I was taking.

    We need to watch out for ourselves.

    Sue
  6. suz45

    suz45 New Member

    Karen:

    You are so right, its not only a communication issue with physicians its a knowledge base issue, I come from a family of Pharmocologist, Paharmicist, pharm D's and due to my experience in Grad school (addictions specialist) I spent a ton of time with the future Doctors of the world.

    Most people would be amazed at how much actul course time is spent on learning about medications by med students and pre med graduate level students as opposed to paharmacists. I think sometimes people foget that the pharmacist is very capable of answering more questions about scripts and drug interactions/condtions than most doctors. I cannot tell you how many times my brother who is a paharmacy diretor in a mjor hospital in Baltiomore has told me about doctors asking him what is the best med for a certain condtion. I am glad to see that they are bothering to ask and not take it all on there own. Pharmacists do not just fill scriots like it is a grocery order, they are well versed in medical condtions not just sub specialities. If I am uncertain about a script the first perso I check in with is the paharmacist, they have never let me down and have alot of knowledge, tend to be cautious and question things.

    Doctors also need more course work in patient/doctor communication and interaction. That appears to be changing. I know my PCP sponsors a med student for a full year regarding dealing with patients issues more effectively.

    thanks for your post it is needed and important,

    in wellness,

    suz45
  7. Adl123

    Adl123 New Member

    Thanks for this information. I think it's really good.

    My only problem is, that I can't find either a doctor or a pharmacist who can tell me if my meds will react with my supplements or herbs. They just don't know. In fact, when I asked one pharmacist, he got really defensive and told me that my illness was probably being caused by my supplements, and that, without even knowing what I was taking!

    Also, because my Dr. only gives his patiesnt 7 minutes, I usually look things up on the Internet and then phone a pharmacist in a big city to ask my questions.

    What a shame that we have to do what we do,up where I live, and are not usually able to just ask our Dr..

    Hugs,
    Terry
  8. kjfms

    kjfms Member

    Hi Sue -- Yes we do have to watch out for ourselves. With so many different medications and the combination of medications it is impossible for anyone to know them all -- including physicians.


    Hi suz45 -- I agree with everything you wrote and you couldn't be more right -- when it comes to prescription drugs I always trust my pharmacist more than my physician because that is what a pharmacist is trained in [medications]. They are more than qualified to answer any questions.


    Hi Terry -- Sorry you are having this problem. Someone had a post on here about a good place to check for supplements I think. You might try the search feature to see if you can find it.


    For anyone interested I use Medscape's drug interaction checker -- you can enter up to 20 drugs and check for any interactions. It is really great.

    Thanks,

    Karen :)
  9. mary124

    mary124 New Member

    Thanks for the article. It was well informed.

    I must be the exception... all of my doctors explain the medication and side effects with me except one doctor. Then the pharmacy goes over it with me as well.

  10. kjfms

    kjfms Member

    that is great -- you are lucky that you have one of the good ones!

    I would say it is like any profession you have some excellent physicians -- some that are OK and some that picked the wrong career...LOL

    I am happy for you that you have a good physician :)

    Take care,

    Karen :)