Factors associated with patients' incomplete understanding of prescriptions

ABSTRACT

BACKGROUND: Patients' understanding of prescriptions is one of the key elements to a successful treatment. In the Philippines, patients do not have the benefit of having pharmacists explaining the prescription when they purchase their medicines. Inability to understand and follow prescriptions may, therefore, contribute to medication non-compliance, which leads to unwanted disease progression, complications, and even premature death. OBJECTIVE: To assess the understanding of Filipino patients of prescriptions given by their doctors and to identify the factors that significantly affect their understanding. METHODS: In total, 392 individuals, using purposive sampling, were interviewed from pharmacies around a government hospital outpatient department (OPD), a private hospital OPD, private clinics, and local health centers in Manila, Philippines. The patients' knowledge about the proper intake of the prescribed drugs was assessed and the factors that were deemed to affect their understanding were then identified. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated according to the various study factors included in the study to measure the association between each study variable and incomplete understanding of prescriptions. A multivariate logistics regression model was constructed applying a stepwise procedure to enter variables in the model. RESULTS: Among the 392 participants, 219(55.9%) patients had an incomplete understanding of prescriptions, 176 (44.9%) were not able to identify the correct dose of the prescribed drug, followed by 103(26.3%) who were not able to identify the name of the drug. Multivariate logistics regression analysis identified only three independent variables to be statistically significant predisposing factors to incomplete understanding of prescriptions non-legible prescriptions (OR=4.598, 95% CI 2.671-7.913), prescriptions with an incomplete set of written instructions (OR=2.108, 95% CI 1.234-3.601), and patient having had no previous use of the prescribed drug or a similar drug (OR=2.126, 95% CI 1.361-3.320). CONCLUSIONS: The results of this study suggest that physicians play an important role in promoting complete understanding of prescriptions. Non-legible prescriptions and prescriptions with an incomplete set of written instructions were found to significantly affect patients' understanding of prescriptions. Physicians should also be more careful in instructing patients who will take the prescribed medications for the first time. These information may be used to enhance better understanding of prescriptions among patients and thereby prevent non-compliance and treatment failure.