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In Brief

Clinical news

Reasons patients withhold information from their doctor examined

By Bianca Nogrady
Between 60 and 80% of people have at some point avoided telling their doctor medically-relevant details about their situation, a US study has found.

In JAMA Network Open, researchers reported the outcomes of a study that aimed to quantify the extent of, and reasons for, patients not disclosing important medical information to their clinician.

The study involved two online surveys taken by a total of 4510 participants that asked people whether they had ever withheld any of seven different types of information, including disagreement with the clinician, lack of understanding of clinician’s instructions, not taking prescription medication as instructed, or about unhealthy diet or exercise habits.

Almost one-half of the patients had at some time disagreed with their clinician but not talked to them about it, and as many as 31.8% had not told their clinician they did not understand their instructions. About one-quarter to one-fifth had not disclosed information about a lack of exercise or unhealthy diet.

In addition, 17.6 to 22.5% of patients had not told their doctor that they had not taken their medication as instructed; 10.4 to 15.5% did not reveal that they were taking another medication; and 8.8 to 13.9% neglected to tell the doctor they had taken someone else’s prescription medication.

Not wanting to feel judged, embarrassment or not wanting to hear how bad a certain behaviour was for them were the main reasons for nondisclosure.

‘These findings indicate that clinicians at times do not receive accurate, relevant information from patients, which may affect clinicians’ diagnoses and recommendations as well as patient care,’ the researchers wrote.

Although the author of an accompanying editorial decried ‘threats to the validity of the clinical interview’, Professor Cindy Gallois, Emeritus Professor of Psychology at the University of Queensland, downplayed the findings’ implications.

‘We don’t have evidence here that this is something that people do on a regular basis or habitually,’ she told Medicine Today. ‘Not many of us would be able to say that we haven’t done at least one of those things once.’

However, she suggested certain techniques could encourage patients to say what they really think, including asking checking questions such as: Is there anything else? Have I understood you correctly? Here’s what I think you said? Is that really what you mean?
JAMA Network Open 2018; e18529.
JAMA Network Open 2018; e185298.