What patients think doctors know: Beliefs about provider knowledge as barriers to safe medication use

• Type of Material: Article
• Authors: Marina Serper, Northwestern University; Danielle M. McCarthy, Northwestern University; Rachel Patzer, Emory University; Jennifer P. King, Northwestern University; Stacy C. Bailey, University of North Carolina; Samuel G. Smith, University College, London; Ruth Parker, Emory University; Terry C. Davis, Louisiana State University; Daniela P. Ladner, Northwestern University; Michael S. Wolf, Northwestern University
• Language: English
• Date: 2013-11-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Elsevier Ireland Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pec.2013.06.030
• Title of Journal or Parent Work: Patient Education and Counseling
• ISSN: 0738-3991
• Volume: 93
• Issue: 2
• Start Page: 306
• End Page: 311
• Grant/Funding Information: The project was also supported by Award Number T32DK077662 from the National Institute Of Diabetes And Digestive And Kidney Diseases.; This project was supported by an unrestricted grant from Target Corporation (PI: Wolf).
• Keywords: EXCHANGES; Social Sciences; Science & Technology; Patient provider communication; LITERACY; PHARMACIST; Public, Environmental & Occupational Health; DRUGS; PHYSICIAN; NONADHERENCE; CARE; ABUSE; RECONCILIATION; Social Sciences - Other Topics; COMMUNICATION; Patient beliefs; Medications; Health literacy; Life Sciences & Biomedicine; Medication; Social Sciences, Interdisciplinary; Safety
• Research Categories: Health Sciences, Pharmacy; Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Objective: We examined patient beliefs about provider awareness of medication use, patient-reported prevalence and nature of provider counseling about medications, and the impact of health literacy on these outcomes. Methods: Structured interviews were conducted at academic general internal medicine clinics and federally qualified health centers with 500 adult patients. Interviewer-administered surveys assessed patients' beliefs, self-reported prevalence and nature of provider counseling for new prescriptions, and medication review. Results: Most patients believed their physician was aware of all their prescription and over the counter medications, and all medications prescribed by other doctors; while a minority reported disclosing over the counter and supplement use. Among those receiving new prescriptions (n= 190): 51.3% reported physician medication review, 77.4% reported receiving instructions on use from physicians and 43.3% from pharmacists. Side effects were discussed 42.9% of the time by physicians and 25.8% by pharmacists. Significant differences in outcomes were observed by health literacy, age, and clinic type. Conclusions: There is a sizable gap between what patients believe physicians know about their medication regimen and what they report to the physician. Practice implications: Discordance between patient beliefs and physician knowledge of medication regimens could negatively impact patient safety and healthcare quality.