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Are Nurses Adquately Prepared to Communicate Adverse Drug Effects to Patients?

Posted Nov 03 2008 9:02pm

Believe it or not, there is still controversy regarding whether to inform patients of possible adverse drug effects (ADE) when a new (to the patient) drug is prescribed. Why withhold such information from a patient? The anti-information camp, which I suspect is quite small compared to the pro-info supporters, feels that patients are simply too suggestible and telling them what ADEs they might see will only cause the patient to imagine that he/she is experiencing those effects.

One study, where patients were given a brochure that listed possible adverse drug effects, found that not to be true. Upon follow-up, the information did not cause the patient to conjure up an imaginary health problem but, if a health problem had occurred, the patient frequently did feel the drug had caused it. So, rather than a “suggestibility” effect, the study revealed a greater prevalence of an “attribution” effect.

I feel strongly—and this is not earthshakingly original—that there is no such thing as having too much knowledge. That goes for me, the nurse, as well as the patient. If a patient might experience adverse drug effects, he/she needs to be prepared. Simple enough, right? It turns out that imparting such information to the patient is more complicated than I would ever have guessed.

There are professionals who are of the opinion that in order to inform our patients of drug risks, we must first understand the neurobiologic factors involved in how patients might react to hearing such news and their ability to absorb the facts. I’m not saying that my understanding those factors wouldn’t be a good thing (again, too much knowledge, no such thing), but I do think that I can do a bang-up job explaining, reassuring and assessing without having to go through a checklist of neurobiolgic considerations.

Are we over analyzing all of this and making it more difficult than it needs to be? What do you think?

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