title: Medication risk communication during rheumatology office visits.
abstract: OBJECTIVE
  We used a multidimensional framework to describe the types of information about medication risks that rheumatologists provide to rheumatoid arthritis (RA) patients during routine office visits.
  
  
  METHODS
  We analyzed 1,094 audiotaped rheumatology office visits involving 450 RA patients. Each patient had up to 3 visits audiotaped. In conjunction with each office visit, patients also completed a self-administered questionnaire and interview and the rheumatologists provided ratings of patient health status.
  
  
  RESULTS
  The number of medication risks discussed per visit ranged from 0-18, with a mean ± SD of 3.23 ± 2.93. The rheumatologist initiated ∼80% of the medication risk discussions. Approximately one-fourth of the discussions (25.6%) were limited to an assessment of whether or not the patient was experiencing a medication side effect. More risks were discussed during visits when changes to the patient's regimen were discussed than when no changes were discussed (X= 3.93, SD = 3.10 and X = 2.20, SD = 2.34, respectively; P < 0.0001). When medications were being proposed for addition to the patient's regimen, the most frequently discussed risk dimensions were the importance of monitoring (30%), probability (29.8%), things the patient should do to minimize risk (25.5%), and risk severity (21.8%).
  
  
  CONCLUSIONS
  Most discussions of medication risks that we observed were quite limited and often restricted to an assessment of whether the patient was experiencing side effects from their current medications. The amount of information that is optimal and how to tailor information to the preferences and abilities of individual patients remain important areas for future research.
authors: Eshelman School of Pharmacy, University of North Carolina, Chapel Hill.
authors: Susan J
authors: SJ
authors: Blalock
authors: Brenda M
authors: BM
authors: DeVellis
authors: Robert F
authors: RF
authors: DeVellis
authors: Betty
authors: B
authors: Chewning
authors: Beth L
authors: BL
authors: Jonas
authors: Betsy L
authors: BL
authors: Sleath
mesh_terms: D018501:Antirheumatic Agents / Q000633:toxicity*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D012219:Rheumatology; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D018501:Antirheumatic Agents