The conversation between physician and patient when medication is prescribed is important and the incorrect use of medications has health and cost implications.
Take 2 of these and call me in the morning. We have all heard that phrase, whether it was in a story told by a friend, a joke, or an experience that we had with our doctor. It doesn’t matter because in each case something very important was missing—the actual information.
The United States spent over $307 billion on prescription drugs in 2010. Over half of Americans take a medication today. What happens when your doctor prescribes a new medicine for you? Let’s take a moment and review a few of the necessary communications that occur throughout the prescribing process. First, a patient goes to see their healthcare provider for a problem that may require a medication—in this case a statin for a new diagnosis of hypercholesterdemia. During the visit the provider tells the patient that they will be given a medication, in most cases a statin. Does the provider ask the patient whether they would like to try lifestyle interventions first? In some cases yes, but in many cases no. What does your physician tell you? What questions do you ask your physician?
There are a number of factors found to be important for a medication to be taken correctly. A few include: the name of the medicine; whether or not the medicine is a brand or generic; what the medicine is for and how it works; how long it will take to see a difference or work; possible side effects; and what things you should and should not take with your medicines.
Unfortunately, studies show that the conversation is somewhat limited, with important information not being shared. In fact, 19% to 39% of doctors were found to have given no information about the new medicine they were prescribing and only about half of the doctors gave dosing directions.1
Medicines have to be used right in order to be effective. Incorrect use of medications has health and cost implications. Medication adherence has been given a great deal of attention, and only recently has the focus of nonadherence illuminated some of the defi cits of these very important conversations. Studies show that better communications make patients more likely to fi ll their medications.2
As the landscape of healthcare is changing to a more participatory interaction, The Agency for Healthcare Research and Quality has recently begun to support patients by educating them on how to ask their doctors for help when discussing their medicines. In any case, we all have to change the conversation.
So why am I discussing this in a journal that is focused on pharmacy benefi ts? One reason is that I believe that payers need to also get into the game. We are seeing more benefi t plans incentivize various activities by healthcare consumers and healthcare providers. This is an activity whose time has come. I am not sure how we will document this interaction but I do believe that this communication is the foundation of appropriate and effi cient healthcare. A process measurement that has, to date, been overlooked, and I believe its time has come. The National Committee for Quality Assurance and payers together should put this on their “To Do” list.
What do you think?