title: Improving effectiveness in communicating risk to patients.
abstract: OBJECTIVE
  To review approaches and tools that pharmacists may use in communicating evidence of risk to older patients and their caregivers.
  
  
  METHODS
  Relevant publications related to tools to communicate evidence to patients were identified through a systematic MEDLINE and Internet search engines using key words: evidence-based medicine/practice, patient, and risk communication. Additional articles were identified through use of the PubMed "related articles" feature and a review of citations of previously identified articles.
  
  
  METHODS
  Relevant English language publications were reviewed, with particular focus on articles about older adults.
  
  
  RESULTS
  Communicating evidence from clinical trials to patients remains a challenge because of patient- and clinician-related barriers. Communicating with older adults faces additional challenges: perceptions of patient involvement in care and uncertainty of drug benefit-to-risk ratio because of the potential increase in adverse events. This is especially true in this population because of their multiple medical conditions. To actively involve patients in health care decisions, an ordered approach to teaching risks and benefits can be valuable. Evidence presented as a general risk estimate should be reinforced with specific numbers to depict patient-specific risk. Understanding may be strengthened with visual aids such as risk ladders or perspective scales. Each step in the process serves as a framework and should consider patients' individual values and beliefs.
  
  
  CONCLUSIONS
  For patients to fully understand medications' risks and benefits, clinicians must use a systematic approach to present data from clinical trials and reinforce patients' comprehension using visual aids. Ultimately, these approaches and tools aim to support patient involvement in health care decisions.
authors.affiliation: Department of Pharmacy Practice, Midwstern University, Chicago College of Pharmacy, Illinois, USA.
authors.forename: Jill S
authors.initials: JS
authors.lastname: Burkiewicz
authors.forename: Kimi S
authors.initials: KS
authors.lastname: Vesta
authors.forename: Anne L
authors.initials: AL
authors.lastname: Hume
mesh_terms: D000368:Aged; D003142:Communication; D064420:Drug-Related Side Effects and Adverse Reactions; D019317:Evidence-Based Medicine; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards; D018802:Patient-Centered Care / Q000592:standards; D010595:Pharmacists / Q000592:standards*; D011369:Professional-Patient Relations; D018570:Risk Assessment