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The Role of Physician Trust and Communication in Filling New Prescriptions [What are the drivers of TRUST?]

Posted Nov 04 2009 10:04pm

jch_cover We know that many patients never fill the prescriptions given to them by their physician, and fewer still are fully compliant. But what patient beliefs are major factors in adherence with drug therapy?

Kathleen Mazor, Susan Billings-Gagliardi, and Melissa Fischer tackled this question in the recent Journal of Communication in Healthcare article “Initial Acceptance of Treatment with Antihypertensive Medication; the Importance of Communication, Trust, and Beliefs.”

Although it seems obvious, it’s important to remember that for drug therapy to actually occur, a patient must accept the recommendation to start the medication.

The major finding in the study was that there are four major beliefs that impact acceptance of drug treatment:

1) trust in the physician

2) the perception that the physician communicated well

3) the belief that medication is effective

4) the belief that doctors don’t prescribe unsafe medications


Mazor’s study is not without its flaws. Data was gathered by random subjects looking at paper material, rather than an analysis of actual patient opinions of their physician and actual behavior regarding treatment initiation. Mazor herself addresses these limitations, stating that, “While it may be a shortcoming, this methodology is an efficient way to systematically test hypotheses about factors that may influence patients’ decision-making about medications.”

As I dove deeper into this issue I stumbled upon the Trust in Physician Scale which is an 11 item instrument that seems to have decent validity. I’ll have to dig deeper but to see if others have already done the studies linking trust to other “empowered patient” issues. One of the demographic factors this scale uncovered is that people over 55 are far more likely to trust their doctor than those who are younger. As the younger, more empowered (and perhaps more cynical) generation matures, the trust and therefore adherence issue will just become worst.

[What are the drivers of TRUST?]

This leads to the real issue I think which is, How can trust be increased? What are the drivers of trust?

And while physicians and other healthcare providers should certainly be interested in this question, the providers of the medication certainly have a stake in the game too. Perhaps pharma reps shouldn’t just detail physicians on the science of the medicine, but offer suggestions on how best to communicate value to appropriate patients?

What are your thoughts on increasing patients’ trust in their physicians?

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