Medication Risk Communication During Rheumatology Office Visits
Article first published online: 27 JAN 2015
Copyright © 2015 by the American College of Rheumatology
Arthritis Care & Research
Volume 67, Issue 2, pages 161–168, February 2015
How to Cite
Blalock, S. J., DeVellis, B. M., DeVellis, R. F., Chewning, B., Jonas, B. L. and Sleath, B. L. (2015), Medication Risk Communication During Rheumatology Office Visits. Arthritis Care Res, 67: 161–168. doi: 10.1002/acr.22424
- Issue published online: 27 JAN 2015
- Article first published online: 27 JAN 2015
- Accepted manuscript online: 29 JUL 2014 11:01AM EST
- Manuscript Accepted: 22 JUL 2014
- Manuscript Received: 23 FEB 2014
- Rheumatology Research Foundation of the American College of Rheumatology
We used a multidimensional framework to describe the types of information about medication risks that rheumatologists provide to rheumatoid arthritis (RA) patients during routine office visits.
We analyzed 1,094 audiotaped rheumatology office visits involving 450 RA patients. Each patient had up to 3 visits audiotaped. In conjunction with each office visit, patients also completed a self-administered questionnaire and interview and the rheumatologists provided ratings of patient health status.
The number of medication risks discussed per visit ranged from 0–18, with a mean ± SD of 3.23 ± 2.93. The rheumatologist initiated ∼80% of the medication risk discussions. Approximately one-fourth of the discussions (25.6%) were limited to an assessment of whether or not the patient was experiencing a medication side effect. More risks were discussed during visits when changes to the patient's regimen were discussed than when no changes were discussed (X= 3.93, SD = 3.10 and X = 2.20, SD = 2.34, respectively; P < 0.0001). When medications were being proposed for addition to the patient's regimen, the most frequently discussed risk dimensions were the importance of monitoring (30%), probability (29.8%), things the patient should do to minimize risk (25.5%), and risk severity (21.8%).
Most discussions of medication risks that we observed were quite limited and often restricted to an assessment of whether the patient was experiencing side effects from their current medications. The amount of information that is optimal and how to tailor information to the preferences and abilities of individual patients remain important areas for future research.