Wednesday, January 30, 2013
QD: News Every Day--Hour-long training session improved how doctors explained new prescriptions
Five basic elements can improve how physicians can talk to patients about new prescriptions, a study found.
An hour-long educational session for doctors improved patient ratings of how doctors explained new prescriptions, according to the controlled trial.
Doctors were audio recorded after the training session to assess how they communicated five basic elements regarding a new prescription to patients, who also received a patient information handout.
Results appeared in the Annals of Family Medicine.
In the study, 7 general internists, 6 family physicians and 14 internal medicine residents from academic internal medicine and family medicine offices at the University of California, Los Angeles prescribed 113 new medications to 82 of 256 patients from February 2009 to 2010.
Physicians were taught about five basic elements of a new prescription, medication name, purpose, directions for use, duration of use, and side effects. The session, which included role-playing, also addressed typical reasons for not doing this, such as fear of scaring patients with side effects.
The mean communication index for medications prescribed by physicians in the intervention group was 3.95 (SD=1.02) compared to control group physicians (2.86, SD=1.23, P less than 0.001), regardless of whether chronic vs. nonchronic medications were prescribed.
Counseling about three of the five communication index components was significantly higher for medications prescribed by physicians in the intervention group, as were patients' ratings of the experience (P=0.02). Higher communication index scores were associated with better patient ratings about information about new prescriptions (P=0.003).
Researchers wrote, "Interestingly, higher MCI scores also were associated with more reports of communication about topics not directly included in the intervention. For example, the intervention encouraged physicians to discuss potential medication side effects with patients, but patients also reported better communication about the risk of experiencing side effects and what to do if side effects occurred."
While not included in the study, researchers added, "This finding, however, suggests that new medication discussions which include more basic elements of medication communication are also more complete in other ways."
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Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:
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Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.
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Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.
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Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.
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Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.
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Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
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