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Patients Unable to Identify Physicians Also Unlikely to Understand Instructions

MANHASSET, NY – Physicians often have a difficult time determining whether hospitalized stroke patients understand instructions and are likely to adhere to their medications.

A recent presentation at the International Stroke Conference 2016 in Los Angeles offers a simple solution: Just ask them who you are.

Researchers from the Northwell Health system in New York point out that stroke survivors are much more likely than general neurology or neurosurgery patients to be unable to identify their attending physician -- increasing the odds that those patients also will misunderstand their medication instructions and care plan, according to the study performed on a neuroscience ward.

For the study, the researchers administered a five-question survey to 146 patients, including 55 stroke patients, 91 general neurology and neurosurgery (non-stroke) patients, or their representatives. The survey assessed patient understanding of their condition leading to admission, care plan, medications, primary attending physician, and follow-up plan. If the patient was unable to communicate, their healthcare representative was interviewed.

Results indicate that 60% of stroke patients were unable to properly identify their primary attending physician, compared to 38.5% of non-stroke patients.

Of those who couldn't identify their care providers, nearly 70% of stroke patients also lacked knowledge of their medication and care plan, compared with 40% of non-stroke patients, the study points out.

"These findings tell us we need to be more vigilant about identifying ourselves as physicians and informing stroke patients about their medications and care plan," explained co-author Jeffrey M. Katz, MD, chief of Neurovascular Services and director of the Stroke Center at North Shore University Hospital. "Patients who do not know their medications well show an increased risk for subsequent strokes, and dissatisfaction with their care. This is, in essence, a patient satisfaction study telling us what we can do to increase patient satisfaction and compliance."

Confusion about caregivers is somewhat understandable, according to co-author Paul Wright, MD, chair of Neurology at North Shore University Hospital and Long Island Jewish Medical Center.

"In the past, you'd have one doctor come into your hospital room and that would be your physician,” Wright said in a Northwell press release. “But over the years we've started developing specialties and subspecialties, and now there are 10 or 15 physicians who show up. The key point is we as healthcare professionals have to inform the patient who's in charge of their care."

The study authors concluded that “stroke patients may require different, extra or more robust communication and education than the general neurology and neurosurgery population. Additionally, emphasis on attending physician identification may improve patient satisfaction and medication compliance.”

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