Do physicians communicate the adverse effects of medications that older patients want to hear?
OBJECTIVE
Physicians routinely discuss adverse effects of medications, but whether discussions match older patients' desire for information is unexplored. This study compares patient preferences for adverse effect discussions with reported physician practice.


METHODS
Cross-sectional survey of a convenience sample of 100 practicing primary care physicians from 9 medical groups and 178 patients recruited from 11 senior centers in the Los Angeles metropolitan area. Physicians listed the adverse effects they typically discuss when prescribing an ACE inhibitor. Patients were given a hypothetical scenario about a new medication prescription, and were asked to circle the three adverse effects they most wanted to hear about from a list.


RESULTS
More than 90 % of patients wanted a physician to discuss medication adverse effects: they wanted information about both dangerous (75 % of patients) and common (66 % of patients) adverse effects. However, patients most commonly chose to hear about adverse effects occurring for < 1 % of patients and selected a wide range of adverse effects for discussion. Physicians reported most frequently educating patients about more common and life-threatening adverse effects. Patients who wanted to discuss more adverse effects were more worried about adverse effects than those wishing to hear fewer (4.0 vs. 3.4 on a 5-point Likert scale;p= 0.02).


CONCLUSIONS
For the studied medication, there was little concordance between the medication adverse effects physicians say they discuss and what patients want to hear. Physicians cannot practically verbally satisfy patients' information desires about the adverse effects of new medications during time-compressed office visits. Innovative solutions are needed.
Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California-Los Angeles, Los Angeles, CA.
Derjung M
DM
Tarn
Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California-Los Angeles, Los Angeles, CA.
Ariela
A
Wenger
Department of Communication and Rhetorical Studies, Syracuse University, Syracuse, NY.
Jeffrey S
JS
Good
Desert Medical Group, Palm Springs, CA.
Marc
M
Hoffing
Eisenhower Medical Center, Eisenhower Argyros Health Center, La Quinta, CA.
Joseph E
JE
Scherger
Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA.
Neil S
NS
Wenger