Patients May Benefit From Additional Education Following DMARD Prescription

Prescribing rheumatologists discussed drug interactions, costs, contraindications, and severity of side effects with less than 50% of the patients in the study to whom they had prescribed disease-modifying antirheumatic drugs.

In a poster at the 2016 American College of Rheumatology Annual Meeting, researchers from the University of North Carolina’s Eshelman School of Pharmacy presented a study on how well patients could recall vital information given to them by their rheumatologist immediately after receiving a prescription for a disease-modifying antirheumatic drug (DMARD).

Asserting that “the amount of DMARD information a patient receives could overwhelm their memory,” the team put together a study at one North Carolina clinic that asked patients immediately following their appointments if they had received a DMARD prescription.

Delesha Carpenter, PhD, was the lead author on the study, and she told MD Magazine that a challenge was finding those at that specific office who had just received their first prescription from this specific class of rheumatic treatments. In total, they gathered 38 who had. The average age of the group was 49 years old, and nine patients (24%) read at or below an 8th grade level.

“An open-ended interview guide was used to assess patient recall of: 1) how to take the DMARD; 2) DMARD benefits; 3) medication side effects; and 4) risks associated with taking the DMARD,” according to the poster, “Patients were also specifically asked, “Can you briefly summarize what your rheumatologist told you about your new arthritis (DMARD) medicine?”

They found that 26% of those they asked (10 of 37) could not accurately recall the benefits of DMARD treatment, and 13% (five of 38) could not recall accurate information about potential side effects.

Factors in decreased levels of recall included lower household income, longer disease duration, and lower health literacy. A week after initial prescription and interview, patients were called to see if they had yet filled the prescription. Patients with lower levels of recall were found no less likely to fill the prescription than those who could more accurately restate the information they had been provided.

The study suggests that patients “may benefit from written educational materials or videos that they can refer to after the visit.” They cited the sample size and homogeneity of their base (overwhelmingly female and white) as limitations on the generalizability of the findings, and also the fact that many of the topics they asked about had not been addressed by the doctors.

Prescribing rheumatologists discussed drug interactions, costs, contraindications, and severity of side effects with less than 50% of the patients. “It may be beneficial to provide patients with written information about these topics if they cannot be adequately covered during a typical office visit,” the poster concludes.

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