Part Four: Doctors Should Be Educating Patients About Compliance With Their Medication Regimen
So far in this series we have looked at the extent of serious adverse drug reactions (ADRs) in the U.S. and how those events could be reduced by by better monitoring of emerging drug-safety issues as well as by better prescribing methods. In this installment we learn how the failure by some doctors to provide essential prescription drug information to their patients is part of the problem.
In September 2006 an entire edition of a leading medical journal was devoted to the issue of medication nonadherence. Why? Perhaps because experts estimate that 20% of serious adverse drug reactions (ADRs) in the U.S. are due to poor compliance with a medication regime.
A series of studies published in the September 25, 2006 edition of the Archives of Internal Medicine identified numerous factors for medication nonadherence, one of which was poor communication by doctors when prescribing new drugs for their patients. One study in particular, which involved 44 doctors, found that when prescribing a new drug these doctors typically only gave their patient information about three of the five following items:
- the drug's name;
- possible ill effects;
- duration of treatment; and,
The same edition of the Archives of Internal Medicine contained an editorial which included this observation:
"Physician failure to provide adequate information at the point of prescription invites nonadherence even from the most fastidious and motivated patients."
A September 26, 2006 article published by Reuters about this particular study provided more details:
To evaluate the counseling provided by doctors.... [p]atients and physicians were surveyed, and the visits were audiotaped. Altogether, 44 physicians prescribed 244 new medications to 185 patients.
"Physicians stated the specific medication name for 74% of new prescriptions and explained the purpose of the medication for 87%," [according to this study]. Doctors explained how long the medication should be taken only 34 percent of the time, and described possible averse effects on only 35 percent of occasions....
This "spotty physician counseling" may be a factor in why people don't comply with treatment, because they don't understand the duration of treatment or proper dosing, or what to do if symptoms don't improve.
Last but not least, this study published in September 2006 by the Archives of Internal Medicine pointed out an important fact that is probably often overlooked. This failure by doctors to provide sufficient drug information to their patients may have the greatest impact on those people who, for one reason or another, are not able to read the label on a medication container or the handout provided by the dispensing pharmacy.
(Posted by: Tom Lamb)