Variation in patients' and pharmacists' attribution of symptoms and the relationship to patients' concern beliefs in medications

Abstract 

Background

The process by which symptoms are identified and characterized is related to adverse drug event reporting. Patient and pharmacist symptom attribution may differ and be related to certain patient characteristics.

Objectives

(1) To compare attribution of symptoms to a cause for patients and pharmacists; (2) to quantify the association between patients' concern beliefs and patient-pharmacist agreement on patients' symptom attribution to medications; and (3) to identify any associations between patients' propensity to agree with pharmacists' assessments of symptom attribution with various clinical and/or sociodemographic characteristics.

Methods

An Internet survey of Medicare beneficiaries was administered by Harris Interactive^®. The survey elicited information on health symptoms that subjects experienced and to whom they reported these symptoms. If subjects did not experience symptoms and did not report them, the reasons for not reporting were elicited. A clinical expert panel reported ratings about respondents' (1) likelihood of the symptom experienced being attributed to a medication and (2) probability of the symptom being attributed to the reason the patient stated. Frequencies of unreported symptoms for each reason/category were examined. Chi-square and Fisher's exact test analyses examined the variations between patients' and pharmacists' ratings of symptom attribution to medications and associations between attribution and patient sociodemographic and clinical characteristics, such as the number of medications used. Independent sample t tests examined how attributions were related to concern beliefs.

Results

Most patients thought their symptom(s) were the result of their disease, something other than medications or age. There was no statistically significant difference between patients' and pharmacists' symptom attribution (χ²=1.376, P=.24). Individuals whose symptom attributions differed from pharmacists were likely to have stronger concern beliefs in medication (t=−3.03, P<.01).

Conclusions

Patients' concern about their medications may be related to their symptom attributions. Older adults may not consider these concerns when asked about their symptom attributions.

Keywords: Symptom attribution, Concern beliefs in medications, Patient-pharmacist agreement