Maybe patients should be in on those drug talks

Two new studies highlight the importance of communication between doctors and patients -- and not just one-sided communication.

In one study, researchers from Yale University found that people 65 and older are quite capable of weighing the pros and cons of their medications, thank you very much. And if allowed to do so, they just might make choices that work well for them.

As the researchers point out, with age can come the development of chronic conditions requiring ongoing, sometimes conflicting, treatment. Adjusting the corresponding medications becomes, therefore, considerably more problematic.

In interviewing people taking five or more medications, the researchers found that study participants initially considered only individual treatment goals, such as reducing their cholesterol or lowering their blood pressure. But when pushed to consider the various ramifications of such treatments, the participants considered broader goals, such as longer life or symptom relief.

Said study author Dr. Terri Fried in a news release:

"Their prioritization of these outcomes revealed what was most important to them, and they chose the treatment option that would mazimize the likelihood of their most desired outcome."

That research was published in the October issue of the Journal of the American Geriatrics Society.

In the second study, from the University of Pennsylvania, people taking the blood thinner warfarin were less likely to suffer a serious bleeding problem if they received both written and verbal instructions on how to do so safely.

The drug, commonly known as Coumadin, can reduce the risk of heart attacks and strokes but can be difficult to manage properly.

Said lead author Dr. Joshua P. Metlay in a news release:

"While we do not know the specific mechanism linking the medication instructions to reduce bleeding risk, it is likely that improved communication about medications leads to increased drug adherence and earlier recognition of medication side effects."

That research was published in the Journal of General Internal Medicine.

And although the placebo debate may be moot in these specific studies (related: What placebos say about the doctor-patient relationship), the new research suggests that many patients may benefit from more, not less, information.

-- Tami Dennis

Photo credit: Ken Hively / Los Angeles Times

Comments

[Jeffrey Kreisberg]

It is well recognized that relationship-centered care provides the patient with the best care. Patients who participate in their healthcare are more "bought" into it and therefore will be more compliant in their treatment. Fifteen percent of patients are misdiagnosed and half are harmed by it. Most misdiagnoses are due to mistakes in physician's thinking. When the patient is involved with their care they ask questions that stimulates thinking that prevents the provider from slipping into the trap of sterotyping patients; no two people are exactly alike. If patients are uncomfortable speaking to their doctors as their equal, then they should be accompanied by an advocate who can ask the questions. For more information please see, www.takingcareofyourhealthcare.com.
Dr. Kreisberg