Physicians need better methods to identify and correct patients' medication noncompliance, according to UCLA researchers who studied the way doctors and patients discussed medication adherence during office visits.
The team, led by Derjung M. Tarn and colleagues, recorded 28 primary care physicians' office visits with 100 patients taking a total of 410 medications and listened for how both parties addressed the topic of medication adherence.
According to their results, published in the June issue of the Journal of the American Geriatrics Society, medication adherence came up in conversation for 62 percent of the 410 medications. For 31 percent of these interactions, the physician simply inquired whether the patient was taking his or her medication. In-depth discussions about adherence, however, occurred for only 4 percent of the drugs. Out of 39 identified instances of non-adherence, patients had voluntarily confessed to 51 percent of the mistakes.
A later focus group involving 22 healthcare providers revealed that although providers feel some responsibility for assessing and resolving reasons for medication nonadherence during office visits, they believed that it was ultimately patients' responsibility to take their medications as prescribed.
According to researchers, physicians may be reluctant to probe further about medication noncompliance because they don't know the right questions to ask. In conclusion, they wrote, "A paradigm of joint provider-patient responsibility may be needed to better guide discussions about medication adherence."