(RxWiki News) Previous studies have estimated that 40 to 80 percent of medical information told to a patient by a doctor is forgotten immediately. New research says there may be an easier way to help patients remember what their doctors told them.
A recent study found that surgical patients who received a simple, multicolor medication instruction sheet before surgery were more likely to correctly follow the instructions on the day of surgery and have a significantly shorter post-operative stay in recovery compared to surgical patients who were given medication instructions traditionally.
The researchers discovered that African-Americans and adults aged 65 years or older were especially less likely to correctly follow medication instructions on the day of surgery.
"Discuss your medication instructions in detail with your doctor."
The lead author of this study was Thomas R. Vetter, MD, MPH, from the Department of Anesthesiology in the School of Medicine at the University of Alabama at Birmingham in Birmingham, Alabama.
The study included 519 surgical patients that were enrolled in the study from October to November 2011 who were given medication instructions through the traditional methods prior to their surgery. Traditional methods of medication instructions usually involve verbal instruction, or highlighted areas of the patient’s medical record.
There also was a group of 531 surgical patients that were enrolled in the study from January to February 2012 who were given a written medication instruction sheet prior to their surgery.
The medical instruction sheets included a list of all medications the patient was supposed to take on the day of surgery, the medications the patient should avoid, and the medications that could be taken as needed. The instruction sheets were all multicolored and verbally reviewed with the patient.
Approximately 50 percent of each surgical group were women, and 75 percent of each group was Caucasian.
The average age of the traditional instruction group was 57 years old versus 56 years old in the instruction sheet group.
"Certain long-term medications should be continued on the day of surgery, and some should be temporarily stopped, but there is no consistency in how patients receive medication instructions before surgery," said Dr. Vetter. "Physician anesthesiologists are responsible for assessing and optimizing patients' preoperative medications, including maximizing their compliance with physicians' instructions. Our effort to enhance patients' understanding of medication use before surgery is important and can increase patient satisfaction by more actively engaging them in their own health care."
The findings showed that 60 percent of those given traditional medication instructions correctly followed the instructions on the day of their surgery, versus 74 percent of those given a detailed instruction sheet.
The researchers determined that the participants who were given the detailed instruction sheet were 83 percent more likely to correctly follow medication instructions on the day of their surgery compared to the participants who were given traditional instructions.
The Caucasian participants were 74 percent more likely to correctly follow their medication instructions the day of their surgery compared to the African-American participants.
Being able to recall receiving both verbal and written medication instructions increased the likelihood of correctly following medication instructions the day of surgery by 51 percent.
The researcher also determined that the patients who received a detailed medication instruction sheet had shorter postoperative recovery stays compared to the patients who received instructions the traditional way (88 minutes versus 94 minutes).
Forty-six percent of the patients who were given a detailed instruction sheet spent less than 90 minutes in recovery versus 54 percent of the tradition method group.
The findings revealed that the patients aged 65 years and older were 33 percent less likely to correctly follow medication instructions on the day of their surgery compared to the patients younger than 65 years old.
Those with a American Society of Anesthesiologists (ASA) physical status of 3 or above were 40 percent less likely to correctly follow medication instructions on the day of their surgery compared to those with an ASA physical status of less than 3.
ASA physical status indicates how severe a patient’s disease is. A score of 3 or above means that the patient has a severe disease with functional limitations.
"Physician anesthesiologists and nurse practitioners typically deliver a lot of verbal information to patients preoperatively, often exceeding patients' short-term memory," concluded Dr. Vetter. "Our findings show that providing patients with a standardized instruction sheet, both written and verbally, with simple language can improve compliance significantly. However, we speculate that a more concerted effort may be required to improve preoperative medication compliance in certain patients such as the geriatric population."
The study was limited because some of the data was based off of self-report, and the researchers did not consider unplanned postoperative admissions on the day of surgery, case cancelations or chronic medication-related case delays.
This study was published on June 17 in Anesthesiology.
