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

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. Methods: 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. Results: 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). Conclusions: 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.