Prescribing new medications: A taxonomy of physician patient communication

Authors

  • Derjung M. Tarn David Geffen School of Medicine at UCLA, Department of Family Medicine, USA
  • John Heritage Professor of Sociology at UCLA
  • Debora A. Paterniti Center for Healthcare Policy and Research University of California, USA
  • Ron D. Hays UCLA School of Medicine, Los Angeles, USA
  • Richard L. Kravitz Department of Internal Medicine University of California, Davis Medical Center, Sacramento, USA
  • Neil S. Wenger Professor of Medicine in the Division of General Internal Medicine and Health Services Research at UCLA.

DOI:

https://doi.org/10.1558/cam.v5i2.195

Keywords:

provider patient communication, physician patient relationship, pharmaceuticals, prescription medication, taxonomy, qualitative analysis

Abstract

Physician-patient communication about new medications can influence patient medication adherence. Little is known about the detailed content of conversations about new medications, or about how physicians and patients word information when discussing new medications. Yet nuances in communication may influence patient comprehension and affect behaviour. A comprehensive coding framework delineating the intricacies of physician-patient discussions is needed to better understand the range of communication about new prescriptions. This study used analytic induction to analyse 185 audiotaped outpatient encounters, during which 243 new medications were prescribed by family physicians, internists and cardiologists in two healthcare settings. Seventysix codes were developed to demonstrate the range of physician counselling about information concerning new prescriptions, such as medication name, purpose, directions for use, side effects, acquisition and monitoring. The conversational content represented by the codes can be used to understand the breadth of conversations regarding new medications, identify sources of potential patient misunderstandings when medication instructions are conveyed, and inform recommendations for desired communication content. The coding system also can be used to measure the quality of new medication discussions for linkage to outcomes and can inform interventions to improve communication when prescribing new drugs.

Author Biographies

  • Derjung M. Tarn, David Geffen School of Medicine at UCLA, Department of Family Medicine, USA
    Derjung M. Tarn is an Assistant Professor of Family Medicine at the David Geffen School of Medicine at UCLA. An active family physician, her research combines qualitative and quantitative methods to understand and improve physician-patient communication about medications.
  • John Heritage, Professor of Sociology at UCLA
    John Heritage is Professor of Sociology at UCLA. A specialist in conversation analysis, he has published over 100 books and articles on social interaction with a particular focus on medicine and politics.
  • Debora A. Paterniti, Center for Healthcare Policy and Research University of California, USA
    Debora A. Paterniti is Adjunct Associate Professor of Internal Medicine and Sociology and Deputy Director of the Center for Healthcare Policy and Research at UC Davis. Her research interests include physician–patient interaction and communication, health inequities, bioethics and qualitative research methods.
  • Ron D. Hays, UCLA School of Medicine, Los Angeles, USA
    Ron D. Hays is Professor of Medicine at UCLA and a Senior Health Scientist at RAND. He has contributed to the development of research instruments to assess patient evaluations of health care, health-related quality of life, and other health outcomes. He has also studied adherence to medical regimens and other issues at the nexus of health, behaviour and the health care system.
  • Richard L. Kravitz, Department of Internal Medicine University of California, Davis Medical Center, Sacramento, USA
    Richard L. Kravitz is Professor of Internal Medicine at the University of California, Davis. He is a general internist with research interests in patient physician communication, interpersonal quality of care in office practice, and evidence-based medicine.
  • Neil S. Wenger, Professor of Medicine in the Division of General Internal Medicine and Health Services Research at UCLA.
    Neil S. Wenger is Professor of Medicine in the Division of General Internal Medicine and Health Services Research at UCLA. He is director of the UCLA Healthcare Ethics Center and director of the NRSA Primary Care Research Fellowship in the UCLA Division of GIM. He is an active general internist and carries out research in the empirical study of clinical ethics, care of and decision making for the older patient, and quality of health care.

Published

2009-03-14

Issue

Section

Articles

How to Cite

Tarn, D. M., Heritage, J., Paterniti, D. A., Hays, R. D., Kravitz, R. L., & Wenger, N. S. (2009). Prescribing new medications: A taxonomy of physician patient communication. Communication and Medicine, 5(2), 195-208. https://doi.org/10.1558/cam.v5i2.195

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