title: What patients think doctors know: beliefs about provider knowledge as barriers to safe medication use.
abstract: OBJECTIVE
  We examined patient beliefs about provider awareness of medication use, patient-reported prevalence and nature of provider counseling about medications, and the impact of health literacy on these outcomes.
  
  
  METHODS
  Structured interviews were conducted at academic general internal medicine clinics and federally qualified health centers with 500 adult patients. Interviewer-administered surveys assessed patients' beliefs, self-reported prevalence and nature of provider counseling for new prescriptions, and medication review.
  
  
  RESULTS
  Most patients believed their physician was aware of all their prescription and over the counter medications, and all medications prescribed by other doctors; while a minority reported disclosing over the counter and supplement use. Among those receiving new prescriptions (n=190): 51.3% reported physician medication review, 77.4% reported receiving instructions on use from physicians and 43.3% from pharmacists. Side effects were discussed 42.9% of the time by physicians and 25.8% by pharmacists. Significant differences in outcomes were observed by health literacy, age, and clinic type.
  
  
  CONCLUSIONS
  There is a sizable gap between what patients believe physicians know about their medication regimen and what they report to the physician.
  
  
  CONCLUSIONS
  Discordance between patient beliefs and physician knowledge of medication regimens could negatively impact patient safety and healthcare quality.
authors.affiliation: Health Literacy and Learning Program, Division of General Internal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, USA; Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Northwestern University Feinberg School of Medicine, Chicago, USA. Electronic address: marina-serper@fsm.northwestern.edu.
authors.forename: Marina
authors.initials: M
authors.lastname: Serper
authors.forename: Danielle M
authors.initials: DM
authors.lastname: McCarthy
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Patzer
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: King
authors.forename: Stacy C
authors.initials: SC
authors.lastname: Bailey
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Smith
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Parker
authors.forename: Terry C
authors.initials: TC
authors.lastname: Davis
authors.forename: Daniela P
authors.initials: DP
authors.lastname: Ladner
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
mesh_terms: D003142:Communication; D003376:Counseling; D003710:Demography; D011307:Drug Prescriptions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007087:Illinois; D007407:Interviews as Topic; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards*; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations
keywords: Health literacy; Medication; Medications; Patient beliefs; Patient provider communication; Safety
references.citation: Ann Intern Med. 2006 Dec 19;145(12):887-94
references.pmid: 17135578
references.citation: Cochrane Database Syst Rev. 2010 Jul 07;(7):CD000336
references.pmid: 20614422
references.citation: Med Care. 1975 Jun;13(6):486-98
references.pmid: 1142855
references.citation: J Am Pharm Assoc (2003). 2011 Jul-Aug;51(4):527-34
references.pmid: 21752776
references.citation: Am J Manag Care. 2011 Feb;17(2):153-60
references.pmid: 21473664
references.citation: Ann Intern Med. 2011 Dec 20;155(12):848-50
references.pmid: 22184692
references.citation: J Gen Intern Med. 2007 Nov;22(11):1523-6
references.pmid: 17786521
references.citation: Med Care. 1999 Nov;37(11):1169-73
references.pmid: 10549619
references.citation: Patient Educ Couns. 2007 Mar;65(3):329-41
references.pmid: 17095179
references.citation: N Engl J Med. 2005 Aug 4;353(5):487-97
references.pmid: 16079372
references.citation: J Altern Complement Med. 2001 Aug;7(4):329-35
references.pmid: 11558775
references.citation: J Altern Complement Med. 2008 Dec;14(10):1263-9
references.pmid: 19032071
references.citation: Healthspan. 1993 Mar;10(3):12-4
references.pmid: 10125342
references.citation: Fam Med. 1993 Jun;25(6):391-5
references.pmid: 8349060
references.citation: Arch Intern Med. 2009 Nov 23;169(21):1996-2002
references.pmid: 19933962
references.citation: Am J Health Syst Pharm. 2006 Jun 1;63(11):1048-55
references.pmid: 16709891
references.citation: J Manag Care Pharm. 2008 Sep;14(7):626-31
references.pmid: 18774872
references.citation: Ann Fam Med. 2005 May-Jun;3(3):223-8
references.pmid: 15928225
references.citation: J Gen Intern Med. 2005 Sep;20(9):800-6
references.pmid: 16117746
references.citation: JAMA. 2003 Mar 5;289(9):1107-16
references.pmid: 12622580
references.citation: Arch Intern Med. 2006 Sep 25;166(17):1855-62
references.pmid: 17000942
references.citation: J Am Pharm Assoc (2003). 2005 Jan-Feb;45(1):48-54
references.pmid: 15730117
references.citation: Soc Sci Med. 2000 Mar;50(6):829-40
references.pmid: 10695980
references.citation: Patient Educ Couns. 2006 Dec;64(1-3):207-16
references.pmid: 16781108
references.citation: Dtsch Med Wochenschr. 2009 Aug;134(33):1620-4
references.pmid: 19650022
references.citation: Health Aff (Millwood). 2011 Jun;30(6):1192-9
references.pmid: 21565838
references.citation: J Am Pharm Assoc (2003). 2009 Mar-Apr;49(2):171-80
references.pmid: 19289343
references.citation: Arch Intern Med. 2008 Nov 24;168(21):2355-61
references.pmid: 19029501
references.citation: J Gen Intern Med. 2006 Aug;21(8):847-51
references.pmid: 16881945
references.citation: J Am Pharm Assoc (2003). 2004 Jan-Feb;44(1):22-9
references.pmid: 14965149
references.citation: Health Expect. 2004 Sep;7(3):235-45
references.pmid: 15327462
references.citation: J Gen Intern Med. 2007 Jan;22(1):6-12
references.pmid: 17351835
references.citation: Am J Med. 2010 Feb;123(2):182.e9-182.e15
references.pmid: 20103029
references.citation: Qual Saf Health Care. 2009 Oct;18(5):402-7
references.pmid: 19812105