Chatty Doctors Help Patients Stick to Rx

Prescription medication adherence may depend on communication

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Some drugs can do wonders to treat chronic diseases like diabetes. However, these drugs may not do much good if they are not taken as prescribed - a problem known as medication non-adherence.

One reason for poor drug adherence may be poor communication between doctors and patients, according to a recent study. Researchers found that patients who said their doctors did not communicate well with them were less likely to adhere to their drug treatment.

This finding suggests that doctors may need to be trained to be better communicators. Doing so could boost drug adherence and improve outcomes for patients.

"Keep an open dialogue with your doctor. "

Neda Ratanawongsa, MD, MPH, of University of California San Francisco, and colleagues studied 9,377 patients taking drugs to lower blood sugar, blood pressure or cholesterol.

Patients were asked through a survey how well their doctors communicated. The researchers measured drug adherence by how long it took patients to refill their prescriptions. That is, a longer delay in refilling prescriptions would be considered poor adherence.

Among the findings:

  • Patients who gave doctors lower ratings for invoking patients in decisions were more likely to have poor drug adherence than those who gave higher ratings, with an absolute difference of 4 percent.
  • Patients who gave doctors lower ratings for understanding patients' problems with treatment were more likely to have poor drug adherence than those who gave higher ratings, with an absolute difference of 5 percent.
  • Patients who gave doctors lower ratings for obtaining confidence and trust were more likely to have poor drug adherence than those who gave higher ratings, with an absolute difference of 6 percent.
  • The links between communication and adherence were somewhat larger for patients taking blood sugar medications than for other drugs.

"Communication matters," Dr. Ratanawongsa said. "Thirty percent of people [in the study] were not necessarily taking their medications the way their doctors thought they were. Rates for non-adherence were 4 to 6 percent lower for patients who felt their doctors listened to them, involved them in decisions and gained their trust. By supporting doctors in developing meaningful relationships with their patients, we could help patients take better care of themselves."

"What is unique about our study is that we found that medication adherence is better if the physician has established a trusting relationship with the patient and prioritizes the quality of communication, even if that communication is not specifically focused on medication adherence," said co-author Andrew Karter, PhD, of the Kaiser Permanente Division of Research.

Dr. Karter is also the principal investigator of the Diabetes Study of Northern California (DISTANCE).

The current study - which was a part of DISTANCE - was supported by the National Institute of Diabetes, Digestive and Kidney Diseases and the National Institute of Child Health and Human Development. The study was published December 31 in JAMA Internal Medicine, formerly the Archives of Internal Medicine

Reviewed by: 
Review Date: 
January 2, 2013
Last Updated:
August 14, 2013