Document Detail


Predictors of rheumatoid arthritis patient-physician communication about medication costs during visits to rheumatologists.
MedLine Citation:
PMID:  20191466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the frequency with which medication costs are discussed, and the predictors of these discussions, during visits between rheumatologists and their patients with rheumatoid arthritis (RA). METHODS: Audiotapes of medical visits, patient questionnaires, medical records, and physician questionnaires were collected from March 2003 to December 2005. Data were collected from 200 RA patients from 4 rheumatology clinics. Audiotapes were coded for the presence of communication about medication costs using a detailed coding instrument. The final analysis sample included 193 patients and 8 rheumatologists. Stepwise multivariable logistic regression was used to examine the role of patient, physician, medication, and relationship characteristics on discussions of medication costs. RESULTS: Despite medication changes being made in more than 50% of the visits, only 34% of those visits included discussions of medication-related costs; 48% of these discussions were initiated by patients. In multivariable logistic regression models, communication about medication costs occurred more often when patients were white (compared with nonwhite) and reported an annual income of $20,000-$59,999 (compared with those earning > or =$60,000). Discussions about medication costs also were more common when physicians were white. CONCLUSION: Although medication changes were common, medication costs were only discussed in one-third of the visits. Communication about medication costs was more common among patients who were white and in a middle income category. Disparities in communication about medication costs have the potential to negatively impact prescribing and subsequent medication use. Further research should examine potential disparities in communication about medication costs.
Authors:
Ashley J Beard; Betsy Sleath; Susan J Blalock; Mary Roth; Morris Weinberger; Gail Tudor; Betty Chewning
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis care & research     Volume:  62     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-12     Completed Date:  2010-06-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  632-9     Citation Subset:  IM    
Affiliation:
Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA. Ashley_Beard@hphc.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Arthritis, Rheumatoid / drug therapy,  economics*
Communication*
Cost of Illness*
Cross-Sectional Studies
Drug Therapy / economics
Female
Humans
Information Seeking Behavior
Logistic Models
Male
Middle Aged
Patient Education as Topic
Physician-Patient Relations*
Prescription Fees*
Rheumatology / economics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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