Lamb G C, Green S S, Heron J
Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee.
Arch Intern Med. 1994;154(23):2753-6. doi: 10.1001/archinte.1994.00420230150018.
When initiating treatment, it has been shown that only one quarter of the physicians discuss potential side effects with patients. There are several possible reasons, but, in particular, many physicians are concerned that the power of suggestion may lead some patients to experience an increase in side effects if they are fully informed. Accordingly, this study was designed to determine whether providing patients with information about potential side effects of new medications increases the reported incidence of those side effects.
All clinic patients are randomly assigned to one of four firms. Two firms served as the intervention group and two served as control groups. All patients receiving new prescriptions for the angiotensin-converting enzyme inhibitors, trimethoprim/sulfamethoxazole, or nonsteroidal anti-inflammatory drugs were recruited. Patients without telephones were excluded. Intervention patients received verbal instructions and a handout describing the name, purpose, dose, and three most common side effects of the drug. Control patients received usual discharge instructions. Patients were interviewed 14 to 21 days later using a standardized questionnaire.
There was no difference in incidence of targeted side effects for specific medications between the study groups (38% vs 37%). Study groups were similar with regard to age, sex, financial status, and type of medication prescribed.
Informing patients of potential side effects prior to starting a new medication does not lead to an increased incidence of those side effects. This should not be a reason for physicians to avoid warning patients of potential side effects.
研究表明，在开始治疗时，只有四分之一的医生会与患者讨论潜在的副作用。原因可能有多种，但特别值得一提的是，许多医生担心，如果患者充分了解情况，暗示的力量可能会导致一些患者出现副作用增加的情况。因此，本研究旨在确定向患者提供新药潜在副作用的信息是否会增加这些副作用的报告发生率。
所有门诊患者被随机分配到四个组中的一组。两个组作为干预组，两个组作为对照组。招募所有接受血管紧张素转换酶抑制剂、甲氧苄啶/磺胺甲恶唑或非甾体抗炎药新处方的患者。没有电话的患者被排除在外。干预组患者接受了口头指导和一份手册，手册描述了药物的名称、用途、剂量以及三种最常见的副作用。对照组患者接受常规出院指导。14至21天后，使用标准化问卷对患者进行访谈。
研究组之间特定药物的目标副作用发生率没有差异（38%对37%）。研究组在年龄、性别、财务状况和所开药物类型方面相似。
在开始使用新药之前告知患者潜在的副作用不会导致这些副作用的发生率增加。这不应成为医生避免向患者警告潜在副作用的理由。
