Personalizing Potential Side-Effect Choices

Mar 07, 2017

“The union of the mathematician with the poet, fervor with measure, passion with correctness, this surely is the ideal.”

William James (1842-1910)
American philosopher and psychologist

Personalizing Potential Side-Effect Choices

TISA Description of the Problem: In helping patients as they are deciding whether to use a medication or not, one of the critical issues will be the potential side-effects of the medications. Medications within a given class, that are appropriate for the patient, may display varying side-effects. Melinda Cobb, M.D. has a nice approach for collaboratively addressing this issue.

Tip: I often let patients know about the key side-effects of several medications that could help them. After doing so, I actively seek input from the patient over which side-effects may be most concerning to them personally as with either of the following questions:

“If we were to use one of these medications, is there a potential side-effect that you would most want to avoid?”

or

“Considering the potential side-effects of these
medications, which medication do you find the most appealing to try?”

TISA Follow-up: Besides its emphasis upon collaborative interviewing, another aspect of these techniques from Melinda that I really like is the fact that they address an important aspect of side-effects that is often not addressed enough. Namely, patients may vary on how problematic a particular side-effect is to them. One patient may find a side-effect to be a mere inconvenience (dry mouth for an accountant) while another patient may find the exact same side-effect to be highly problematic (dry mouth for an actor). In my practice I have sometimes been surprised at patient’s thoughts on side-effects, assuming that a patient may view a particular side-effect as very bad when indeed, for him or her, it is “no big deal” or vice versa. The above techniques nicely help to ensure that the clinician assumes nothing and is truly guided by the input of the patient, yet another example of the fine art of clinical interviewing.

Tip provided by:

Melinda Cobb, M.D.