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Enhancing Communication About Newly Prescribed Medications

Enhancing Communication About Newly Prescribed Medications

When physicians prescribe a new medication, there are many instances when basic information about the drug is not discussed with patients. Guidelines recommend that older adults be educated about the reason physicians prescribe medications, how to take them, and their potential side effects. “It has been postulated that better patient knowledge about medications may lead to better adherence,” says Derjung M. Tarn, MD, PhD. It has been reported that patients who have better and more discussions with their doctors about prescription medications are more adherent to them than those receiving less information. Many interventions have been launched in clinical studies to improve patient education and counseling about medications, but few have targeted the content of physician communication. “Physician-targeted interventions vary, but research shows that the information doctors provide to patients tends to be lacking in many cases,” Dr. Tarn explains. “They rarely address the cost of medications and oftentimes don’t adequately monitor adherence.” Greater exploration is needed into the information exchange during conversations with patients after prescribing medications. Prescription Medication Intervention In a study published in the Annals of Family Medicine, Dr. Tarn and colleagues tested an intervention that involved training physicians to discuss five basic facts about a prescribed medication with patients: 1) the medication’s name, 2) its purpose, 3) directions for its use, 4) duration of use, and 5) potential side effects. How well physicians communicated these facts to patients was measured using the Medication Communication Index (MCI), a previously developed, 5-point index in which 1 point is given for discussion about each of five topics relating to a new prescription. Training consisted of a 1-hour interactive...

Can Transdermal Nicotine Improve MCI?

In non-smoking patients with amnestic mild cognitive impairment (MCI), 6 months of transdermal nicotine (15 mg/day) appear to improve cognitive test performance, but not clinical global impressions of change. A small study found that transdermal nicotine was associated with improvements in attention, memory, psychomotor speed, and patient/informant rating of cognitive improvement in those with MCI. Abstract: Neurology, January 10,...

A New Look at Diagnosing Alzheimer’s Disease

More than years ago, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s and Related Disorders Association (now the Alzheimer’s Association) released diagnostic criteria for Alzheimer’s disease (AD). At the time, AD was thought of only as a dementia. The 1984 criteria stated that the ultimate AD diagnosis was dependent on pathology. Since that time, the basic concepts of AD have changed significantly, and researchers have uncovered important clues on the diagnosis of AD and dementia. Updating Diagnostic Criteria for Alzheimer’s The National Institute of Aging of the NIH and the Alzheimer’s Association recently called a meeting to discuss whether or not the diagnostic criteria required updating. Three subgroups were established to discuss the criteria, based on what would be the biggest changes in the concepts of AD (Table 1). These included that AD starts years and perhaps decades before dementia develops and symptoms are visible. The result of this collaboration was the establishment of new guidelines based on four articles collectively called the “National Institute on Aging/ Alzheimer’s Association Diagnostic Guidelines for Alzheimer’s Disease.” The document was published in the April 22, 2011 online edition of Alzheimer’s & Dementia. “The field is changing rapidly, and the hope is biomarkers will become more widely available and used in diagnoses.” “The pre-symptomatic phase of AD includes people who have laboratory evidence of the disease but no symptoms,” explains Guy M. McKhann, MD, who was a member of the group that updated the diagnostic criteria. “The minimal cognitive impairment (MCI) phase includes people with memory problems who haven’t reached the stage of being demented. The final phase includes those...

Conference Highlights: RSNA 2010

RSNA 2010, the annual meeting of the Radiological Society of North America, was held from November 29 to December 3 in Chicago. The features below highlight just some of the studies that emerged from the meeting. » Assessing Breast Cancer Screenings With MRI » Delaying or Preventing Osteoarthritis in At-Risk Patients » Can Walking Slow Cognitive Decline? Assessing Breast Cancer Screenings With MRI The Particulars: Guidelines currently recommend annual screening with breast MRI in women with a known gene mutation or a strong family history that indicates a lifetime risk of breast cancer greater than 20%. However, there is insufficient evidence to recommend for or against MRI screening in women who have already had breast cancer. Data Breakdown: A retrospective review of initial screening breast MRI examinations of 1,026 women was conducted in a 5-year study. Of these 1,026 women, 327 had a genetic or family history of breast cancer, and 646 had a personal history of treated breast cancer. MRI testing identified 25 of 27 cancers in the group, amounting to a sensitivity rate of 92.6%. The cancer yield in women with a personal history of breast cancer (3.1%) was double that of women with a genetic or family history (1.5%). Take Home Pearl: Women with a personal history of breast cancer should consider annual screening with MRI in addition to mammography. Additional studies are necessary to establish guidelines for screening these women. Delaying or Preventing Osteoarthritis in At-Risk Patients [back to top] The Particulars: Osteoarthritis is one of the most common forms of arthritis and affects an estimated 27 million Americans over the age of 25. Known risk factors for cartilage degeneration...
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