One of the keys to improving the physician-patient relationship is for doctors to provide clear instructions as to the whys and hows of using medication and the specifics of treatment.

In the last installment of this series (in October), we discussed how creating a strong physician-patient relationship is critical to improving a patient’s satisfaction. But what happens next? The physician hands the patient the prescription. Will the patient then use the medication?

Even if the patient has all the trust in the world for this physician, there are still a number of hurdles. Does the patient know why they are using the medication and exactly how to use it? This information is basic to patient adherence yet it doesn’t always get transmitted. One small study done in Denmark looked at how often doctors gave patients basic information along with the prescription. The results were shocking. Only two out of three patients were told the diagnosis or the duration of treatment. While patients were told the name of the medication and how many times a day to use it, the effect of the medication was not described 76% of the time, adverse effects were never explained and information on drug price was never given. It seems like there is plenty of room for improvement in the transmission of drug information.

It also seems this may represent an opportunity for other interested parties to step to the plate to provide physicians with materials they can use for patient education. Perhaps they can provide information directly to patients on why the medication should be used and what effects—good and bad—should be anticipated.

While some physicians may be telling patients exactly what they need to know about their medications, just telling patients isn’t good enough. The information—from the simplest instructions to the most complex—has to be in writing.

For example, one time a mother came to my clinic with her child who had eczema and who had failed treatment with another dermatologist. The child’s skin was so dry, I asked what kind of soap was being used on the child. The mom said, “Ivory,” which is what dermatologists would classify as a drying product. Normally, we would recommend a milder cleanser like Dove for a child with eczema. I asked the mom what cleanser the previous dermatologist had recommended, and she reported, “Dove or Ivory.” I’m confident the previous dermatologist recommended “Dove not Ivory,” but putting it in writing would have been more effective.

Patients cannot be expected to remember what a doctor tells them, especially in the stressful environment of a medical visit. If it isn’t in writing, all bets are off regarding what the patient will remember. Having straightforward patient information materials would be a huge help, and the drug package inserts don’t typically provide that.

In the next installment (in February), we will discuss a simple, low cost, yet extraordinarily powerful tool for improving patients’ adherence to treatment. Have a great holiday season and healthy New Year.

  • Steven Feldman, M.D.

    Dr. Steven Feldman is Professor of Dermatology and Public Health Sciences at Wake Forest Baptist Medical Center. Steve studies patient adherence at North Carolina’s Wake Forest Baptist Medical Center. He is also Chief Science Officer of Causa Reseach, an adherence solutions company (www.causaresearch.com), founder of www.DrScore.com, and author of “Compartments” and “An Illustrated Dictionary of Behavioral Economics for Healthcare Professionals.”

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