Article Figures & Data
Figures
- Figure 1
Flowchart of study participants.
- Figure 2
Medical Communication Index scores for medications prescribed by intervention and control group physicians.
a <.001.
b <.01.
- Figure 3
Percentage of medications for which Medication Communication Index component was discussed.
a P <.01.
b P <.05.
c P ≤.001.
Tables
Characteristic Prescribing aNew Medication(N = 18) Intervention Group (n = 10) Control Group (n = 8) Age, mean (SD), y 38.8 (11.3) 41.6 (13.7) 35.3 (6.5) Female, No. (%) 7 (39) 4 (40) 3 (38) Race/ethnicity, No. (%) White 11 (61) 6 (60) 5 (63) Asian 7 (39) 4 (40) 3 (38) Years in practice, mean (SD) 13.7 (11.8) 16.4 (14.3) 10.3 (7.3) Note: No difference between intervention and control group physicians was statistically significant.
Characteristic All Patients (N = 256) Prescribed a New Medication (n = 82) Not Prescribed a New Medication (n = 174) Prescribed a New Medication Intervention Group (n = 46) Control Group (n = 36) Age, mean (SD), y 64.8 (10.5) 60.5 (8.0) 66.8 (11.0) 60.3 (7.9) 60.7 (8.3) Female, No. (%) 150 (58.6) 50 (61.0) 100 (57.5) 30 (65.2) 20 (55.6) Race/ethnicity, No. (%) White 158 (61.7) 49 (59.8) 109 (62.6) 26 (56.5) 23 (63.9) African-American 43 (16.8) 15 (18.3) 28 (16.1) 7 (15.2) 8 (22.2) Hispanic 24 (9.4) 12 (14.6) 12 (6.9) 9 (19.6) 3 (8.3) Asian 21 (8.2) 5 (6.1) 16 (9.2) 3 (6.5) 2 (5.6) Other 8 (3.1) 1 (1.2) 7 (4.0) 1 (2.2) 0 (0) Education, No. (%) High school or less 45 (17.7) 15 (18.5) 30 (17.4) 10 (22.2) 5 (13.9) Some college 85 (33.3) 28 (34.8) 57 (32.8) 15 (33.3) 13 (36.1) College graduate 125 (49.0) 38 (46.9) 87 (50.0) 20 (44.4) 18 (50.0) Health literacy score, mean (SD)a 6.7 (0.89) 6.8 (0.49) 6.7 (1.0) 6.8 (0.53) 6.9 (0.44) Medications and dietary supplements, mean (SD), No. 6.8 (4.4) 6.7 (3.9) 6.8 (4.6) 6.7 (3.6) 6.6 (4.2) Confidence about interacting with physicians, mean score (SD)b 8.6 (1.5) 8.6 (1.5) 8.6 (1.6) 8.9 (1.1) 8.3 (1.9) Seen by internal medicine physician, No. (%) 158 (61.7) 55 (67.1) 103 (59.2) 30 (65.2) 25 (69.4) Seen by attending physician, No. (%) 225 (87.9) 71 (86.6) 154 (88.5) 40 (87.0) 31 (86.1) Seen by patient’s regular physician, No. (%) 214 (86.0) 64 (82.1) 150 (87.7) 36 (83.7) 28 (80.0) Previous visits to physician, No. (%) Never 36 (14.8) 15 (19.2) 21 (12.7) 5 (11.9) 10 (27.8) 1-2 35 (14.4) 11 (14.1) 24 (14.6) 7 (16.7) 4 (11.1) 3-5 49 (20.2) 13 (16.7) 36 (21.8) 7 (16.7) 6 (16.7) 6-12 48 (19.7) 14 (18.0) 34 (20.6) 8 (19.1) 6 (16.7) >12 75 (30.9) 25 (32.1) 50 (30.3) 15 (35.7) 10 (27.8) - Table 3
Effect of Intervention on Patients’ Reports About Physician Communication and Medication
Report No. of Patients All Patients Intervention Group Control Group P Value a About physician Overall communication, mean score (SD) 82 5.67 (0.60) 5.74 (0.54) 5.59 (0.66) .49 Trust in physician, mean score (SD) 82 4.68 (0.55) 4.72 (0.52) 4.62 (0.59) .68 Communication about new medication, No. (%)b 111 7.90 (2.81) 8.78 (2.23) 6.87 (3.09) .02 What medicine is called 107 103 (96.3) 56 (94.9) 47 (97.9) .53 What medicine is for 106 105 (99.1) 57 (98.3) 48 (100) .36 Why medicine is important to take 103 90 (87.4) 51 (89.5) 39 (84.8) .63 How to take the medicine 102 95 (93.1) 54 (96.4) 41 (89.1) .07 How long to take medicine 103 92 (89.3) 56 (96.6) 36 (80.0) .03 How to get further medicine supply (if applicable) 81 69 (85.2) 42 (82.4) 30 (90.9) .37 Whether medicine has side effects 103 75 (72.8) 50 (86.2) 25 (55.6) .001 Risk of getting side effects 105 64 (61.0) 43 (76.8) 21 (42.9) .003 What to do if side effects occur 100 63 (63.0) 40 (74.1) 23 (50.0) .008 Interactions with other medicines 100 62 (62.0) 43 (81.1) 19 (40.4) <.001 About new medication immediately after the visit Planning to take new medication, No. (%) 110 107 (97.3) 59 (98.3) 48 (96.0) .56 Certainty about taking new medication, mean score (SD) 111 8.94 (2.16) 9.30 (1.96) 8.51 (2.29) .04 Importance of new medication, mean score (SD) 111 3.61 (0.62) 3.65 (0.61) 3.57 (0.64) .52 Worry about condition medication is for, mean score (SD) 111 2.36 (1.02) 2.45 (1.08) 2.25 (0.93) .32 Note: Data are presented as mean (SD) unless otherwise indicated. Unit of analyses for overall communication and trust in physician is the patient; unit of analyses for all other outcomes is the new medication. Overall communication ranges from 1 to 6; trust in physician ranges from 1 to 5; communication about new medication and certainty about taking new medication range from 0 to 10; and importance of new medication and worry about condition range from 1 to 4. Higher scores indicate better communication, more trust, and greater certainty, importance, and worry.
- Table 4
Relationship between Medication Communication Index (MCI) and Patients’ Reports about Physician and Medication
Report No. Mean MCI Score (SD) R2 P Valuea About physician Communication about new medication 108 0.13 .003 What medicine is called (about right) 100 3.45 (1.2) .17 What medicine is called (insufficient) 4 3.75 (1.0) What medicine is for (about right) 102 3.44 (1.2) <.0 01 What medicine is for (insufficient) 1 4 (-) Why medicine is important to take (about right) 87 3.51 (1.2) .42 Why medicine is important to take (insufficient) 13 2.96 (1.4) How to take the medicine (about right) 92 3.50 (1.2) .87 How to take the medicine (insufficient) 7 3.14 (1.4) How long to take medicine (about right) 89 3.60 (1.2) .03 How long to take medicine (insufficient) 11 2.27 (1.3) How to get further medicine supply 69 3.54 (1.2) (if applicable) (about right) .71 How to get further medicine supply 12 3.79 (1.3) (if applicable) (insufficient) Whether medicine has side effects (about right) 72 3.78 (1.1) .02 Whether medicine has side effects (insufficient) 28 2.80 (1.3) Risks of getting side effects (about right) 61 3.81 (1.1) <.0 01 Risks of getting side effects (insufficient) 41 2.84 (1.3) What to do if side effects occur (about right) 61 3.83 (1.1) <.001 What to do if side effects occur (insufficient) 36 2.88 (1.3) Interactions with other medicines (about right) 59 3.70 (1.1) .07 Interactions with other medicines (insufficient) 38 3.05 (1.3) About new medication Planning to take new medication 104 3.45 (1.2) .46 Not planning to take new medication 3 2.83 (1.8) Certainty about taking new medication 108 0.01 .62 Importance of new medication 108 <0.01 .76 Worry about condition medication is for 108 0.03 .11 Note: The MCI is a 5-point index calculated by assigning 1 point to each of the following elements if they are discussed during an office visit: medication name, purpose of use, duration of use, potential side effects. Counseling about the number of tablets or sprays and how often to use a medication is given 0.5 points each.
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↵a P value describes differences between MCI scores for categorical variables, and relationship between MCI and patient reports for continuous variables.
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The Article in Brief
Intervention to Enhance Communication About Newly Prescribed Medications
Derjung M. Tarn , and colleagues
Background This study tests a program to improve doctor-patient communication about newly prescribed medications. In particular, the study looks at 5 elements of communication about medications (discussion of medication name, purpose, directions for use, duration of use, and side effects), as well as patients' ratings of communication about new prescriptions.
What This Study Found A program to improve patient education and counseling about new medications by targeting physician communication appears to be effective. On average, doctors who participate in the program address more than 1 of 5 additional elements of basic information compared with control group physicians; they also have more discussions than control group doctors about all 5 major elements emphasized by the intervention. Furthermore, the intervention results in patients reporting better communication about medication information.
Implications
- When doctors introduce a new medication, it sets the stage for whether and how patients will initiate use of the medication. The authors call for future research testing the clinical impact of the intervention.
Supplemental Appendixes 1-2
Supplemental Appendix 1. Study Intervention Slides; Supplemental Appendix 2. Patient Intervention Handout
Files in this Data Supplement:
- Supplemental data: Appendixes 1-2 - PDF file, 6 pages, 1.6 MB
