Gist and verbatim communication concerning medication risks/benefits

- Audiotapes of RA patient office visits were used to identify major gist themes.
- Most discussion concerning medication risks was superficial.
- Serious side effects were not always interpreted as significant safety concerns.
- Communicating the gist that medication is effective predicted patient satisfaction.

ObjectivesTo describe the information about medication risks/benefits that rheumatologists provide during patient office visits, the gist that patients with rheumatoid arthritis (RA) extract from the information provided, and the relationship between communication and medication satisfaction.MethodsData from 169 RA patients were analyzed. Each participant had up to three visits audiotaped. Four RA patients coded the audiotapes using a Gist Coding Scheme and research assistants coded the audiotapes using a Verbatim Coding Scheme.ResultsWhen extracting gist from the information discussed during visits, patient coders distinguished between discussion concerning the possibility of medication side effects versus expression of significant safety concerns. Among patients in the best health, nearly 80% reported being totally satisfied with their medications when the physician communicated the gist that the medication was effective, compared to approximately 50% when this gist was not communicated.ConclusionStudy findings underscore the multidimensional nature of medication risk communication and the importance of communication concerning medication effectiveness/need.Practice implicationsHealth care providers should ensure that patients understand that medication self-management practices can minimize potential risks. Communicating simple gist messages may increase patient satisfaction, especially messages about benefits for well-managed patients. Optimal communication also requires shared understanding of desired therapeutic outcomes.