How much time does it take to prescribe a new medication?
OBJECTIVE
To measure the length of time spent discussing all aspects of new prescriptions and guideline-recommended aspects of counseling, and to evaluate factors associated with duration of discussion.


METHODS
We analyzed tape recordings in which 181 patients received 234 new medication prescriptions from 16 family physicians, 18 internists, and 11 cardiologists in 2 healthcare systems in Sacramento, California between January and November 1999.


RESULTS
Of the mean total visit time of 15.9min (S.D.=434s), a mean of 26s (S.D.=28s) was allocated to guideline-recommended components and a mean of 23s (S.D.=25s) was allocated to discussion of all other aspects of new prescription medications. The majority of time spent discussing individual new prescriptions was dedicated to: medication purpose or justification, directions and duration of use, and side effects. On average, more complete discussion of these components was associated with more time. More time was spent talking about guideline-recommended information if patients were in better health, if there was a third party in the room, and if the medication belonged to a psychiatric, compared to an ear, nose, throat medication class. Less time was spent discussing over-the-counter (OTC) medications and those prescribed to patients with a previous visit to the physician.


CONCLUSIONS
Higher quality information transmission between physicians and patients about new medications requires more time, and may be difficult to achieve in short office visits.


CONCLUSIONS
Time-compressed office visits may need to be redesigned to promote improved provider-patient communication about new medications.
Tarn
Derjung M
DM
Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA. dtarn@mednet.ucla.edu
Paterniti
Debora A
DA
Kravitz
Richard L
RL
Heritage
John
J
Liu
Honghu
H
Kim
Sue
S
Wenger
Neil S
NS
D000328:Adult; D002140:California; D002309:Cardiology / Q000706:statistics & numerical data; D003142:Communication; D003376:Counseling; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009819:Office Visits / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018709:Statistics, Nonparametric; D013637:Tape Recording; D013996:Time and Motion Studies