Stopping long-term drug therapy in general practice. How well do physicians and patients agree?.
BACKGROUND
GPs have a particular responsibility to limit the occurrence of polypharmacy and adverse drug reactions, and to discontinue unnecessary drug therapy.


OBJECTIVE
The aim of the present study was to measure the extent to which patients and physicians agree upon information communicated in a consultation when a drug is withdrawn.


METHODS
A total of 272 Norwegian GPs and 272 patients filled in questionnaires after a consultation in which a long-term drug therapy had been discontinued. Their answers were compared and the agreement measured by kappa statistics.


RESULTS
There was 100% concordance between physicians and patients as to what drug had been discontinued. Most of the drugs (72%) were cardiovascular. There was fair agreement as to whether the drug was to be stopped abruptly or gradually withdrawn (kappa 0.61) and whether a follow-up appointment had been scheduled (kappa 0.41). Physicians were not able to judge patients' satisfaction accurately (kappa 0.20). Most patients (73%) were satisfied or very satisfied with the decision to withdraw the drug, and many commented that good communication and close follow-up is a prerequisite for successful withdrawal of long-term drug treatment.


CONCLUSIONS
Discontinuation of drug treatment was welcomed by most patients. Physicians and patients agreed completely as to what drug was to be discontinued, and fairly well about other factual aspects, but physicians were not able to judge patients' satisfaction accurately.
Straand
J
J
Section for General Practice/Family Medicine, Department of General Practice and Community Medicine, University of Oslo, N-0318 Oslo, Norway.
Sandvik
H
H
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D016001:Confidence Intervals; D003266:Continuity of Patient Care; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004358:Drug Therapy / Q000592:standards* / Q000706:statistics & numerical data; D005194:Family Practice / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008134:Long-Term Care / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009664:Norway; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D019338:Polypharmacy