Patient interpretations of prescription order quantitative statements.

OBJECTIVES: To characterize the variability in patient understanding and interpretation of quantitative statements from prescription orders and to evaluate the influence of sociodemographic characteristics on how patients interpret quantitative statements. METHODS: Participants were recruited in both a clinic and pharmacy setting in Kentucky. Patients were given a survey that asked for general background information and two questions pertaining to their experience with topical products. Then, patients were read a scenario and asked to use a provided tube of cream and squeeze out what they considered a small amount. RESULTS: 100 eligible patients participated in the study, with the majority having previous counseling on the use of topical products. The mean (±SD) cream weight representing a small amount was 0.36 ± 0.50 g. Regression analysis demonstrated a significant nonlinear relationship for two of the patient characteristics, age and body mass index (BMI), with the greatest effect in the middle of age and BMI distributions (at approximately age 50 years and BMI 30 kg/m²). No evidence indicated that gender, race, education, or previous experience with or education about topical products had any effect on cream weight perception. CONCLUSION: Patients demonstrated tremendous variability in the interpretation of a small amount of topical product cream. Further research should be conducted to determine whether policy changes are warranted to require more specific prescription order instructions in the outpatient setting.

Drug sample provision and its effect on continuous drug therapy in an indigent care setting.

OBJECTIVE: To assess the continuity and consistency of drug therapy among indigent patients following drug sample provision. DESIGN: Retrospective study. SETTING: Indigent ambulatory care. PATIENTS: 129 adult patients, identified as having been given a drug sample between January 1, 2004, and February 27, 2004. INTERVENTIONS: Analysis of data regarding the sample regimen, duration, rationale for sample provision, therapeutic indication, and subsequent therapy prescribed in the 6 months following sample provision. MAIN OUTCOME MEASURES: Lengths of gaps between sample provision and subsequent prescribed therapy were analyzed to evaluate the effect of sample provision on the continuity and consistency of drug therapy. RESULTS: Of the 52 patients for whom continuous therapy was indicated, interruptions in therapy occurred in 50% (mean duration, 51.1 +/- 37.8 days; range, 2-123). Of the 65 patients who were prescribed subsequent therapy, 89.2% were prescribed the exact same drug, 9.2% a different drug in the same class, and 1.5% a different drug in a different class. Following sample provision, only 2 (3.1%) patients were prescribed generic medications. CONCLUSION: Significant interruptions in drug therapy frequently followed sample provision in those requiring continuous treatment. On average, patients experienced interruptions in therapy for nearly 2 months. The majority of patients who were prescribed subsequent therapy were prescribed the same drug as the drug sample initially provided.