Most patients can't recall own diagnosis

WASHINGTON, Aug 04, 2005 (United Press International via COMTEX) -- U.S. researchers report that most patients are unable to list their medications, diagnoses, treatment plans and common side effects of prescribed medications after they leave the hospital.

In a new study published in the Mayo Clinic Proceedings, 72 percent of patients were not able to list the names of all their medications, and 58 percent were unable to remember their diagnoses.

"Some of the things we need to do as physicians is to set aside a little more time and allow patients to ask more questions," lead author Dr. Amgad Makaryus, of the Department of Medicine at North Shore University Hospital in Manhasset, N.Y., told United Press International.

Makaryus said spending five minutes more explaining the diagnosis and what patients should or should not do would help improve patient understanding.

He worked with Dr. Eli Friedman, of the Department of Medicine at the State University of New York, in 1999 studying 43 patients at a Brooklyn teaching hospital to see if they understood their discharge diagnosis.

"It basically brings to our attention a little more how with groundbreaking research and new technology we can treat patients very well, but even with the best of treatments we might not get the desired results because the patient does not understand what the physician is doing," Makaryus said. "If they (the patients) have a better understanding, they can improve the outcome and they can improve the treatment by going along with the plan."

Makaryus said doctors need to explain treatment plans better, as well as the names and purposes of medications. They also should involve each patient as a crucial member of the healthcare team.

"All methods that enhance the patient's understanding of his or her discharge treatment plan focus on one central aspect -- proper communication," Friedman said in a statement.

Dr. Edward Rosenow III, with the Mayo Clinic's Division of Pulmonary and Critical Care Medicine in Rochester, Minn., suggested 11 ideas for improving aftercare for patients in an editorial in the same issue of Mayo Clinic Proceedings.

"We need a better way of helping them to understand what the disease is and the importance of taking the medication as directed," Rosenow told UPI. "It's not just hospitals, but it's physicians' offices everywhere. It's uniform all over. It's education. Time spent with the patients to educate them. It is probably not going to happen because physicians are not paid extra time to repeat instructions."

Rosenow suggested sending patients to a health educator to receive more instructions and directions about their illnesses. A health educator -- a new specialty -- is someone who is certified that knows a lot about health issues and how to express them to a patient in the language they understand.

"The physician is a major part of the problem because we assume that they are going to take it (the medication) exactly as prescribed," Rosenow said. "It's the lack of communication both ways."

Rosenow said not having English as a primary language is a major factor in patient non-compliance, particularly if the interpreter, who is usually a family member or friend, is not well-versed in English. He also said some cultures do not take medicine, which could be a factor.

Makaryus said the study did not include patients who did not speak English, but he concurred that the language barrier is one of the components of the problem. He said further study is needed to see how patient understanding could be improved by looking at how different techniques -- such as the use of a health educator -- could affect patient understanding.

"Whether lack of communication between physician and patient is actually the cause of patient unawareness of discharge instructions or if this even affects patient outcome requires further study," Friedman said.

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Andrew Damstedt is an intern for UPI Science News. E-mail: sciencemail@upi.com

Copyright 2005 by United Press International.