Three out of four patients who visit the doctor end up leaving the office with a drug prescription in their hand. How many of these patients suffer side effects from their drugs? According to a recent study, almost one in five.
Yet most of these are never recorded in patients' medical records, despite the anxiety and discomfort they cause. Clearly, some disconnect in patient-physician communication exists, and that gap needs to be bridged.
The drugs that most often caused complications were antibiotics, antidepressants, and nonsteroidal anti-inflammatory agents. The most frequently reported problems were gastrointestinal symptoms, sleep problems, fatigue, and mood changes. Physicians often take these types of reactions for granted in the course of medical therapy. However, it is important to realize that these events are not minor to patients; physicians may underestimate the impact of these events on patient satisfaction, healthcare utilization, and quality of life.
Patients who reported drug complications were significantly less satisfied with their overall quality of care, especially if their doctors had failed to discuss potential side effects with them. Half of the patients who reported drug complications said that they had experienced worry or discomfort, and about half sought medical attention for these complications. In addition, over a third reported that the problem had interfered with work, leisure, or activities of daily living.
In 20% of patients, drug complications lasted more than 3 months. The researchers point out that many doctors think that discussing side effects with their patients makes them more likely to occur. But patients whose doctors didn't talk about possible drug-related problems were more likely to report complications, not less, as well as being significantly less satisfied with their care. Patients who know in advance about potential side effects may handle them better or have less concern about them. Therefore, improving patient education about side effects is a promising intervention that could reduce patient-reported drug complications.
Journal of General Internal Medicine 2000;15:149-154