title: An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: The role of written and spoken communication.
abstract: We tested the feasibility and efficacy of an electronic health record (EHR) strategy that automated the delivery of print medication information at the time of prescribing.
  
  
  
  Patients (N=141) receiving a new prescription at one internal medicine clinic were recruited into a 2-arm physician-randomized study. We leveraged an EHR platform to automatically deliver 1-page educational 'MedSheets' to patients after medical encounters. We also assessed if physicians counseled patients via patient self-report immediately following visits. Patients' understanding was objectively measured via phone interview.
  
  
  
  122 patients completed the trial. Most intervention patients (70%) reported receiving MedSheets. Patients reported physicians frequently counseled on indication and directions for use, but less often for risks. In multivariable analysis, written information (OR 2.78, 95% CI 1.10-7.04) and physician counseling (OR 2.95, 95% CI 1.26-6.91) were independently associated with patient understanding of risk information. Receiving both was most beneficial; 87% of those receiving counseling and MedSheets correctly recalled medication risks compared to 40% receiving neither.
  
  
  
  An EHR can be a reliable means to deliver tangible, print medication education to patients, but cannot replace the salience of physician-patient communication.
  
  
  
  Offering both written and spoken modalities produced a synergistic effect for informing patients.
authors.affiliation: Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA. Electronic address: l-curtis@northwestern.edu.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Curtis
authors.affiliation: Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Mullen
authors.affiliation: Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Russell
authors.affiliation: Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA.
authors.forename: Aimee
authors.initials: A
authors.lastname: Fata
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, University of North Carolina, Chapel Hill, USA.
authors.forename: Stacy C
authors.initials: SC
authors.lastname: Bailey
authors.affiliation: PatientWisdom, New Haven, USA and Connecticut Institute for Primary Care Innovation, Hartford, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Makoul
authors.affiliation: Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D037001:Directive Counseling; D001330:Electronic Data Processing; D057286:Electronic Health Records; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D055553:Prescription Drugs / Q000627:therapeutic use; D055656:Prescriptions; D011320:Primary Health Care / Q000379:methods; D014956:Writing
chemical_list: D055553:Prescription Drugs
keywords: Patient education; Physician counseling; Prescription medications