title: Life disruptions for midlife and older adults with high out-of-pocket health expenditures.
abstract: OBJECTIVE
  Physicians prescribing new medications often do not convey important medication-related information. This study tests an intervention to improve physician-patient communication about newly prescribed medications.
  
  
  METHODS
  We conducted a controlled clinical trial of patients in 3 primary care practices, combining data from patient surveys with audio-recorded physician-patient interactions. The intervention consisted of a 1-hour physician-targeted interactive educational session encouraging communication about 5 basic elements regarding a new prescription and a patient information handout listing the 5 basic elements. Main outcome measures were the Medication Communication Index (MCI), a 5-point index assessed by qualitative analysis of audio-recorded interactions (giving points for discussion of medication name, purpose, directions for use, duration of use, and side effects), and patient ratings of physician communication about new prescriptions.
  
  
  RESULTS
  Twenty-seven physicians prescribed 113 new medications to 82 of 256 patients. The mean MCI for medications prescribed by physicians in the intervention group was 3.95 (SD = 1.02), significantly higher than that for medications prescribed by control group physicians (2.86, SD = 1.23, P <.001). This effect held regardless of medication type (chronic vs nonchronic medication). Counseling about 3 of the 5 MCI components was significantly higher for medications prescribed by physicians in the intervention group, as were patients' ratings of new medication information transfer (P = .02). Independent of intervention or control groups, higher MCI scores were associated with better patient ratings about information about new prescriptions (P = .003).
  
  
  CONCLUSIONS
  A physician-targeted educational session improved the content of and enhanced patient ratings of physician communication about new medication prescriptions. Further work is required to assess whether improved communication stimulated by the intervention translates into better clinical outcomes.
authors: Department of Medicine, University of Pennsylvania, Philadelphia, 19104, USA. dgrande@wharton.upenn.edu
authors: David
authors: D
authors: Grande
authors: Frances K
authors: FK
authors: Barg
authors: Sarah
authors: S
authors: Johnson
authors: Carolyn C
authors: CC
authors: Cannuscio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D002908:Chronic Disease / Q000191:economics* / Q000523:psychology / Q000628:therapy; D017047:Cost Sharing / Q000191:economics / Q000331:legislation & jurisprudence; D005382:Financing, Personal / Q000191:economics / Q000331:legislation & jurisprudence; D005582:Foundations; D005102:Health Expenditures / Q000331:legislation & jurisprudence; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000331:legislation & jurisprudence; D007407:Interviews as Topic; D016365:Liability, Legal; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D010817:Physician-Patient Relations; D013315:Stress, Psychological / Q000209:etiology; D014481:United States