QUOTE OF THE MONTH:

# 78 August 2006

"All galaxies, stars, planets, and human beings are manifestations
of disturbances in a tenuous sea. They are waves, streams, ripples,
flurries in a ceaseless change."

John Pfeiffer
from The Changing Universe


(continues below)

mental health professional trainings
primary care professional trainings
psychological assessment supervision and consultations
Shawn Christopher Shea
links and recommended readings

INTERVIEWING TIP OF THE MONTH

# 78 August 2006

"Determining a Patient's Attitudes Towards Taking Medications in General"

TISA Description of the Problem: When taking a medication history, during the initial interview for a mental health professional or during the initial History & Physical in a primary care setting, one of the most important questions is sometimes overlooked - "Does the patient take medications as prescribed?" No medication can work from inside a bottle.

As we go through life all of us develop attitudes about medications in general and these attitudes follow us into physicians' offices when we are patients. Uncovering the patient's unique attitudes towards medications is critical before prescribing for the first time, for some patients may be frightened about medications or hesitant to use them, sometimes for quite good reasons. In this regard I have always found the following question to be an invaluable one when wrapping up my medication history, "Mr. Jones, do you feel that you are particularly sensitive to medications?" It gives me a great read on the patient's basic feelings towards medications.

Naturally, after asking such a question, it becomes important to get a concrete idea of how this attitude plays itself out in the real world of the patient's home. In the following interviewing tip, Michael Applebaum, M.D. provides a clever way for gaining insight on this very point..

Tip: I have found the following question to help me determine a patient's opinion on how sensitive he or she is to medications and what approach they may take to my own medication recommendations:

"Mr. Jones, when you take aspirin or Tylenol or Motrin for a headache or pain of some sort, how much do you usually take?"

By actually seeing how a patient approaches these medications, I often get a more accurate picture of their beliefs about medications and their own personal approach to taking them.

TISA Follow-up: This excellent tip by Michael Applebaum may provide a more reliable method of directly seeing how a patient's basic attitudes towards medications plays out in real life. Their approach to the taking of a common "everyday" medication can often uncover a more accurate idea of how they will approach the medications, that we are about to prescribe, than their words alone.

Tip provided by:

Michael J. Applebaum, M.D.
Boise, Idaho