What patients think doctors know: Beliefs about provider knowledge as barriers to safe medication use

Abstract

ObjectiveWe examined patient beliefs about provider awareness of medication use, patient-reported prevalence and nature of provider counseling about medications, and the impact of health literacy on these outcomes. MethodsStructured interviews were conducted at academic general internal medicine clinics and federally qualified health centers with 500 adult patients. Interviewer-administered surveys assessed patients’ beliefs, self-reported prevalence and nature of provider counseling for new prescriptions, and medication review. ResultsMost patients believed their physician was aware of all their prescription and over the counter medications, and all medications prescribed by other doctors; while a minority reported disclosing over the counter and supplement use. Among those receiving new prescriptions (n=190): 51.3% reported physician medication review, 77.4% reported receiving instructions on use from physicians and 43.3% from pharmacists. Side effects were discussed 42.9% of the time by physicians and 25.8% by pharmacists. Significant differences in outcomes were observed by health literacy, age, and clinic type. ConclusionsThere is a sizable gap between what patients believe physicians know about their medication regimen and what they report to the physician. Practice implicationsDiscordance between patient beliefs and physician knowledge of medication regimens could negatively impact patient safety and healthcare quality.