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Women don't tell it all when it comes to the medications they're taking

Patient Safety Monitor Alert, February 25, 2004

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Healthcare providers should spend extra time questioning women about their medication usage, concludes a new study which shows that women are unlikely to tell healthcare providers about all of the medications they take.

"We really need to inquire better about patients taking herbal and over-the-counter medications," says Timothy Tracy, PhD, one of the study's authors and professor at the University of Minnesota College of Pharmacy. "The care providers need to ask, and patients need to tell. Neither one is doing a good job." The study appears in the February 24 issue of the Journal of Obstetrics and Gynecology.

Women are also unlikely to mention medications that the physician did not prescribe. For example, patients did not always tell their gynecologist that they were taking high blood pressure medication prescribed by another physician.

"Patients may not perceive that their blood pressure medication was something their gynecologist needed to know about," says Tracy. "Sometimes, patients don't associate their disease and medication with the individual physician they're seeing at any given time if the physician is not the one treating that condition or if they didn't prescribe the medication."

Among the more than 570 study participants, about 97% took an over-the-counter medications, 92% took prescription medications, and 59% used herbal supplements.

Study participants were asked open-ended questions about the mediations that they take. The interviewer then conducted a system-by-system analysis, asking patients whether they took any medications for situations such as headaches, upset stomachs or achy joints.

The patients were then given a list of common mediations, including vitamins, herbal supplements, prescription medications, and over-the-counter drugs, and were asked whether they took any of them.

Researchers found that every set of questions revealed additional medications that the patients hadn't reported. They also discovered that while a patient may have reported a particular medication during the first visit's interview, she failed to mention it during a subsequent interview unless prompted.

They uncovered several potentially serious drug interactions. The most commonly prescribed medication was antibiotics, which may reduce the effectiveness of birth control pills. Other patients who were taking prescription antidepressants also self-medicated with St. John's wort, an herbal supplement that has potentially harmful interactions with prescription antidepressants.

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