Clinicians know the value of a complete medical history. The difference can be substantial between someone whose parents both developed macular degeneration early in life vs. someone whose family never had an issue with it, or a pack-a-day smoker vs. a tobacco-free patient, or a patient taking blood pressure lowering medications vs. a patient with no history of hypertension. However, patients seem to think it’s not in their best interest to reveal these details when in your exam lane.
In a duet of surveys totaling 4,510 American participants, researchers uncovered that most patients avoided disclosing at least one piece of clinically relevant information. In one survey, 61.4% of participants made the surprising admission while a whopping 81.1% concurred in the second study. Clinically relevant information included seven specific items; the studies asked whether participants had “ever avoided telling a health care provider” that they:
1. Did not understand the provider’s instructions.
2. Disagreed with the provider’s recommendation.
3. Did not exercise or did not exercise regularly.
4. Had an unhealthy diet or how unhealthy their diet was.
5. Took a certain medication (i.e., deliberately did not mention a certain agent).
6. Did not take their prescription medication as instructed.
7. Took someone else’s prescription medication.
Most patients withheld this information for fear of “being judged or lectured,” the researchers reported.
“The clinician-patient relationship requires honest and open communication between both parties,” the investigators concluded in their paper. They added that future studies should find ways to “increase the trust and communication between patients and their clinicians as well as patients’ comfort with disclosing information to their clinicians.”
|Gurmankin A, Scherer A, Zikmund-Fisher B, et al. Prevalence of and factors associated with patient nondisclosure of medically relevant information to clinicians. JAMA Netw Open. 2018;1(7):e185293.|