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Types of information physicians provide when prescribing antidepressants

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Abstract

BACKGROUND: Providing antidepressant information to patients may foster greater adherence to therapy.

OBJECTIVE: To assess physician information-giving while prescribing antidepressants, and to identify factors that influence the provision of information.

DESIGN: Randomized experiment using standardized patients (SPs). Standardized patients roles were generated by crossing 2 clinical conditions (major depression or adjustment disorder) with 3 medication request types (brand-specific, general, or none).

PARTICIPANTS: One hundred and fifty-two general internists and family physicians recruited from solo and group practices and health maintenance organizations; cooperation rates ranged from 53% to 61%.

MEASUREMENTS: We assessed physician information-giving by analyzing audio-recordings of interactions between physicians and SPs, and collected physician background information by survey. Generalized estimating equations were used to examine the influence of patient and physician factors on physicians’ provision of information.

RESULTS: One hundred and one physicians prescribed antidepressants, accounting for 131 interactions. The mean age of physicians was 46.3 years: 69% were males. Physicians mentioned an average of 5.7 specific topics of anti-depressant-related information (of a possible maximum of 11). The most frequently mentioned topic was purpose (96.1%). Physicians infrequently provided information about the duration of therapy (34.9%) and costs (21.4%). Standardized patients who presented with major depression received less information than those with adjustment disorder, and older and solo/private practice physicians provided significantly less information to SPs.

CONCLUSIONS: Physicians provide limited information to patients while prescribing antidepressants, often omitting critical information that may promote adherence. Mechanisms are needed to ensure that patients receive pertinent antidepressant information.

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Authors and Affiliations

  1. Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, WI, USA

    Henry N. Young PhD

  2. Center for Health Services Research in Primary Care, University of California, Davis, CA, USA

    Robert A. Bell Ph.D & Richard L. Kravitz MD, MSPH

  3. Department of Communication, University of California, Davis, CA, USA

    Robert A. Bell Ph.D

  4. Departments of Family Medicine and Psychiatry and Center to Improve Communication in Health Care, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    Ronald M. Epstein MD

  5. Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA

    Mitchell D. Feldman MD, MPhil

  6. Department of Internal Medicine, University of California, Davis, CA, USA

    Richard L. Kravitz MD, MSPH

Authors
  1. Henry N. Young PhD
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  2. Robert A. Bell Ph.D
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  3. Ronald M. Epstein MD
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  4. Mitchell D. Feldman MD, MPhil
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  5. Richard L. Kravitz MD, MSPH
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Corresponding author

Correspondence to Henry N. Young PhD.

Additional information

This work was supported by a research supplement for under-represented minorities, and grant 5 R01 MH064683-03 from the National Institute of Mental Health. We are grateful for the individuals who assisted with this project: Sheila Krishnan and Jason Mudrock.

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Young, H.N., Bell, R.A., Epstein, R.M. et al. Types of information physicians provide when prescribing antidepressants. J Gen Intern Med 21, 1172–1177 (2006). https://doi.org/10.1111/j.1525-1497.2006.00589.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00589.x

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