title: Patient recall of health care provider counseling for opioid-acetaminophen prescriptions.
abstract: OBJECTIVE
  The aim of this study was to determine the frequency and nature of physician, nurse, and pharmacist verbal counseling at the time of a new prescription for an opioid-acetaminophen containing medication as recalled by patients.
  
  
  METHODS
  A mixed methods approach with data from cross sectional, structured interviews was used.
  
  
  METHODS
  The settings were one academic emergency department in Chicago, IL and one outpatient pharmacy at a public hospital in Atlanta, GA.
  
  
  METHODS
  One hundred forty-nine patients receiving a new prescription for an opioid-acetaminophen medication were enrolled.
  
  
  METHODS
  Interviews assessed patient recall of counseling they received from their physician, nurse, and pharmacist upon receiving the new prescription. Their responses were unitized and assigned to categories.
  
  
  RESULTS
  One hundred forty-nine patients were enrolled; 61.1% African American and 58.4% female. Seven major categories of responses were noted; frequencies of patient recall for counseling in these categories were reported. Four categories related to the content of the counseling discussion were (1) details of administration (patient recall counseling from: physician/nurse only 44.3%, pharmacist only 5.4%, both providers 12.8%); (2) activities to avoid and side effects (36.2%, 4.7%, 8.7%); (3) medication indication (32.9%, 4%, 4%); and (4) addictive potential (9.3%, 1.3%, 0%). Three categories describe patients' recall of the interaction in broad terms: (5) being referred to print informational material accompanying the prescription (MD/RN only 7.4%, pharmacist only 20.1%, both providers 2.7%); (6) having questions solicited (0%, 11.4%, 0%); (7) having no interaction relating to medication counseling (3.4%, 32.2%, 1.3%).
  
  
  CONCLUSIONS
  Patients infrequently recall counseling from providers on topics that are important to prevent harm from opioid-acetaminophen prescriptions. Future patient-centered clinical research should target identifying optimal strategies to convey these critical messages.
authors.affiliation: Health Literacy and Learning Program, Feinberg School of Medicine, Northwestern University, Chicago, USA; Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: McCarthy
authors.forename: Kenzie A
authors.initials: KA
authors.lastname: Cameron
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: King
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Mullen
authors.forename: Stacy Cooper
authors.initials: SC
authors.lastname: Bailey
authors.forename: Kara L
authors.initials: KL
authors.lastname: Jacobson
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Di Francesco
authors.forename: Terry C
authors.initials: TC
authors.lastname: Davis
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Parker
authors.forename: Mike S
authors.initials: MS
authors.lastname: Wolf
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects*; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000517:prevention & control; D010146:Pain / Q000188:drug therapy; D055656:Prescriptions
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D000082:Acetaminophen
keywords: Acetaminophen; Hydrocodone; Medication Counseling; Opioids