Communication between primary-care doctors and patients can reduce medication-related problems, a new study suggests.

Primary-care doctors who encourage their patients to let them know about bothersome side effects of prescribed medicationsand who address such problems promptlycan reduce the chances that patients will be harmed by the medications. These results are published in the January 24 issue of Archives of Internal Medicine.

Researchers recruited 661 patients at four adult primary-care practices in Boston. They also surveyed physicians whose patients experienced medication-related symptoms. A panel of physicians and pharmacists reviewed each reported symptom to determine whether it constituted a true adverse drug event (ADE).

While many patients experienced ADEs, they failed to report a surprising number of them (31%) to their doctors. And while physicians often did change the therapies of patients who reported medication problems, they didnt order such changes 24% of the time.

For every symptom that patients experienced but failed to report, one in five resulted in an adverse drug event that could have been prevented or been made less severe, says the studys lead author, Saul N. Weingart, M.D., Ph.D., director of the Center for Patient Safety at Dana-Farber Cancer Institute, in Boston. For every symptom that patients did report but doctors failed to act on, two-thirds resulted in an adverse drug event.

The investigators didnt inquire about patients reasons for not reporting some of the adverse side effects. They speculate, however, that patients may have been reluctant to discuss side effects that were common, relatively mild or embarrassing (such as diarrhea or sexual dysfunction).

The moral of the study: Patients have a lot to tell us about symptoms they experience due to their medications, Dr. Weingart says. And there is a great deal of opportunity for doctors to prevent harm by asking questions regularly about medications and medication-related problems, and by taking patients comments seriously.

Dr. Weingart and his colleagues are now exploring whether technological tools, such as e-mail reminder messages, can encourage patients to report side effects to their physicians.

Weingart SN, Gandhi TK, Seger AC, et al. Patient-reported medication symptoms in primary care. Arch Intern Med 2005 Jan 24;165(2):234-40.

Vol. No: 142:2Issue: 2/15/05