Drugs & Therapy Perspectives

, Volume 31, Issue 2, pp 68–76 | Cite as

Do physicians communicate the adverse effects of medications that older patients want to hear?

  • Derjung M. TarnEmail author
  • Ariela Wenger
  • Jeffrey S. Good
  • Marc Hoffing
  • Joseph E. Scherger
  • Neil S. Wenger
Original Research Article


Background and objectives

Physicians routinely discuss the adverse effects of medications but whether these discussions match older patients’ desire for information is an area that has not been explored. This study compares patient preferences for adverse effect discussions with reported physician practice.


A cross-sectional survey of a convenience sample of 100 practicing primary care physicians from nine medical groups, and 178 patients recruited from 11 senior centers in the Los Angeles metropolitan area. Physicians listed the adverse effects they typically discuss when prescribing an ACE inhibitor. Patients were given a hypothetical scenario about a new medication prescription and, from a list of adverse effects, they were then asked to circle the three they most wanted to hear about.


More than 90 % of patients wanted a physician to discuss medication adverse effects; they wanted information about both dangerous (75 % of patients) and common (66 % of patients) adverse effects. However, patients most commonly chose to hear about adverse effects occurring for <1 % of patients, and selected a wide range of adverse effects for discussion. Physicians most frequently reported educating patients about adverse effects which were more common and life-threatening. Patients wishing to discuss additional adverse effects were more worried about adverse effects than those wishing to hear fewer (4.0 vs. 3.4 on a 5-point Likert scale; p = 0.02).


For the studied medication, there was little concordance between the medication adverse effects physicians say they discuss and what patients want to hear. Physicians cannot practically verbally satisfy patients’ information desires about the adverse effects of new medications during time-compressed office visits. Innovative solutions are needed.


Knee Pain Common Adverse Effect Potential Adverse Effect Senior Center Specific Adverse Effect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Derjung M. Tarn, Ariela Wenger, Jeffrey S. Good, Marc Hoffing, Joseph E. Scherger and Neil S. Wenger report no conflicts of interest or financial disclosures.

Dr. Tarn was supported by a University of California–Los Angeles Mentored Clinical Scientist Development Award (5K12AG001004), and by the University of California–Los Angeles Older Americans Independence Center (National Institutes of Health/National Institute on Aging grant P30-AG028748). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute on Aging or the National Institutes of Health.


  1. 1.
    National Center for Health Statistics. Health, United States, 2011: with special feature on socioeconomic status and health [Table 99]. Hyattsville (MD). US Department of Health and Human Services; 2012.Google Scholar
  2. 2.
    Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998;279(15):1200–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Shrank WH, Polinski JM, Avorn J. Quality indicators for medication use in vulnerable elders. J Am Geriatr Soc. 2007;55(Suppl 2):S373–82.PubMedCrossRefGoogle Scholar
  4. 4.
    AHRQ. Questions are the answer. Agency for Healthcare Research and Quality, Rockville (MD). Available from: Accessed 27 Dec 2012.
  5. 5.
    Aspden P, Institute of Medicine (US). Committee on Identifying and Preventing Medication Errors. Preventing medication errors. Quality chasm series. Washington, DC: National Academies Press; 2007. Available from:
  6. 6.
    Huang SW. The Omnibus Reconciliation Act of 1990: redefining pharmacists’ legal responsibilities. Am J Law Med. 1998;24(4):417–42.PubMedGoogle Scholar
  7. 7.
    Nair K, Dolovich L, Cassels A, et al. What patients want to know about their medications. Focus group study of patient and clinician perspectives. Can Fam Physician. 2002;48:104–10.PubMedCentralPubMedGoogle Scholar
  8. 8.
    Lisper L, Isacson D, Sjoden PO, Bingefors K. Medicated hypertensive patients’ views and experience of information and communication concerning antihypertensive drugs. Patient Educ Couns. 1997;32(3):147–55.PubMedCrossRefGoogle Scholar
  9. 9.
    Ziegler DK, Mosier MC, Buenaver M, Okuyemi K. How much information about adverse effects of medication do patients want from physicians? Arch Intern Med. 2001;161(5):706–13.PubMedCrossRefGoogle Scholar
  10. 10.
    Bull SA, Hu XH, Hunkeler EM, et al. Discontinuation of use and switching of antidepressants: influence of patient-physician communication. JAMA. 2002;288(11):1403–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Tarn DM, Heritage J, Paterniti DA, Hays RD, Kravitz RL, Wenger NS. Physician communication when prescribing new medications. Arch Intern Med. 2006;166(17):1855–62.PubMedCrossRefGoogle Scholar
  12. 12.
    MacLean CH. Quality indicators for the management of osteoarthritis in vulnerable elders. Ann Intern Med. 2001;135(8 Pt 2):711–21.PubMedCrossRefGoogle Scholar
  13. 13.
    Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36(8):588–94.PubMedGoogle Scholar
  14. 14.
    Powers BJ, Trinh JV, Bosworth HB. Can this patient read and understand written health information? JAMA. 2010;304(1):76–84.PubMedCrossRefGoogle Scholar
  15. 15.
    Mechanic D. How should hamsters run? Some observations about sufficient patient time in primary care. BMJ. 2001;323(7307):266–8.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Dickinson D, Raynor DK. What information do patients need about medicines? Ask the patients—they may want to know more than you think. BMJ. 2003;327(7419):861.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Unni E, Farris KB. Determinants of different types of medication non-adherence in cholesterol lowering and asthma maintenance medications: a theoretical approach. Patient Educ Couns. 2011;83(3):382–90.PubMedCrossRefGoogle Scholar
  18. 18.
    Duke J, Friedlin J, Ryan P. A quantitative analysis of adverse events and “overwarning” in drug labeling. Arch Intern Med. 2011;171(10):944–6.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Derjung M. Tarn
    • 1
    Email author
  • Ariela Wenger
    • 1
  • Jeffrey S. Good
    • 2
  • Marc Hoffing
    • 3
  • Joseph E. Scherger
    • 4
  • Neil S. Wenger
    • 5
  1. 1.Department of Family MedicineDavid Geffen School of Medicine at UCLA, University of California–Los AngelesLos AngelesUSA
  2. 2.Department of Communication and Rhetorical StudiesSyracuse UniversitySyracuseUSA
  3. 3.Desert Medical GroupPalm SpringsUSA
  4. 4.Eisenhower Medical Center, Eisenhower Argyros Health CenterLa QuintaUSA
  5. 5.Division of General Internal Medicine and Health Services ResearchDavid Geffen School of Medicine, University of California–Los AngelesLos AngelesUSA

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