Better Communication: The Right Prescription | Consumer Health Information Corporation

Better Communication: The Right Prescription

Bonnie L. East, PharmD Candidate 2007
Shenandoah University
Prepared during Consumer Health Information Corporation Clerkship

Everyone wants to receive the best care from their doctor and pharmacist. In order to receive this care, patients must not hold back any information from the doctor. They should also ask questions in order to understand how to follow their treatment and prescription instructions.

The February 2007 issue of Consumer Reports published the results of a survey entitled “Get Better Care from Your Doctor.” The key findings of the study were:

One out of every three patients is embarrassed to talk about their symptoms with their doctors.
One out of every three doctors did not discuss the side effects of prescribed drugs with their patients.

Consumer Reports surveyed 39,090 of their subscribers and 335 primary care physicians. The authors of the article mentioned that their subscribers might not be representative of the population as a whole.¹

It all boils down to communication

The common theme with the results of this survey is communication. There are many symptoms and side effects being dismissed that are very important and need to be known. A doctor can only make a correct diagnosis if the patient explains all of the symptoms they have. When one out of three patients hold back information about their symptoms and “decide” which ones are important to relay to the doctor, the doctor might not make the correct diagnosis. For example, if the patient has dry eyes then the doctor wouldn’t want to prescribe something that makes this symptom worse.

Similarly, the patient needs to know how to recognize and manage possible side effects. If one out of three doctors are not discussing side effects of prescription drugs with their patients, they will not know what to do if they experience a side effect. For example, if a medication causes diarrhea, the patient might stop or delay taking a dose if this isn’t explained ahead of time. Once the doctor decides a treatment for a patient, the doctor must clearly communicate instructions and outcomes. If these topics are not covered during the appointment, a pharmacist can be another source of information. When it comes to medications, the patient and pharmacist must also have the same type of open and clear communication.

Don’t be embarrassed

The study reported that patients often do not tell their doctors about symptoms they are embarrassed to talk about. Examples include bowel movements, sexual activity and psychosocial disorders. A doctor does not know all of your symptoms so this is when you can help by telling them what symptoms are bothering you and be as honest as possible. Some symptoms that should always be discussed with your doctor are:

Blood in stool or urine
Vomiting or coughing blood
Feelings of suicide
Strange lumps
A mole that is growing, changing, bleeding or painful
Chest pains
Breathlessness
Unexplained weight loss
Sudden change in vision

Side effects need to be discussed

Every drug can cause side effects. Doctors want to provide the best treatment possible with minimum side effects. So, you should discuss these with your doctor every time you receive a new prescription. Side effects can be related to dose, strength, length of treatment or how well your body can tolerate/manage the drug. For example, strong narcotic pain relievers can cause constipation.² This side effect can be prevented if you know what to expect. Another example of a side effect with antidepressant medications is feelings of suicide.³ Some common warning signs are feelings of shame, guilt, hopelessness and social isolation. This is a serious problem that the doctor should be informed of immediately. So, if the side effects aren’t explained, don’t be afraid to ask.

What can the consumer do to open the lines of communication with their doctor?

First, choose a doctor and pharmacist that you feel comfortable talking to. Try asking friends or family members for suggestions. If you don’t feel comfortable with your doctor you are not going to want to talk about your problems.
Before you go to your appointment, prepare a list of your symptoms. Use this as a reference in case you get nervous or forget while you are in the office.
Be honest with your doctor. For example, if he asks you how many drinks you have in a day, tell him how many drinks you have in a day. Alcohol can possibly affect lab tests or interact with some medications. The amount of alcohol you consume could also affect the decisions your doctor makes about treatment.
If your doctor gives you a new prescription make sure you ask about drug interactions with your current medications and common side effects. Find out which ones you can prevent or treat and which ones you should call him immediately about.
Take notes while you are in the appointment with the doctor. Studies show that people generally forget 50% of the information they receive from the doctor by the time they reach the pharmacy.⁴
When the appointment is finished and you still have questions, ask your pharmacist! They are specialists who can help you learn how to take your medications correctly.

References

“Get Better Care from Your Doctor” Consumer Reports, February 2007; 32-36.
Haddox D, Joranson D, Angarola R, et al. “The Use of Opioids for the Treatment of Chronic Pain.” http://www.ampainsoc.org/advocacy/opioids.htm American Pain Society. Accessed 15 February 2007.
Hershel J, Kaye J, Jick S. “Antidepressants and the Risk of Suicidal Behaviors” JAMA. 2004; 292: 338-343.
Ley P. “Memory for Medical Information.” British Journal of Social and Clinical Psychology. 1979; 18 (2): 245-55.