Friday, 18 Jan 2019

You are here

Patients Don't Always Tell the Truth

Sometimes patients withhold information from their doctors, and a new study suggests that as much as 60 - 80% of patients consciously omit information to their doctors, despite knowing this may bear on their health and well-being.

In two national online surveys of 4510 US adults and their self-reported medical behaviors, most participants reported withholding at least 1 of 7 types of medically relevant information, especially when they disagreed with the clinician’s recommendations or misunderstood the clinician’s instructions. The most commonly reported reasons for not disclosing information included not wanting to be judged or hear how harmful their behavior is.

From these 2 surveys we see that most patients were white (79-84%) with mean ages of 36 and 61 years.  Key findings included:

  • 61-81% avoided disclosing at least 1 type of information
  • 46% disagreed with the clinician’s recommendation
  • 31% did not understand the clinician’s instructions
  • 62-82% failed to disclose as they did not want to be judged or lectured
  • 61-76% not wanting to hear how harmful the behavior is
  • 59-61% not wanting to be embarrassed  

Those most likely to withhold information were women (OR 1.38-1.88), younger (OR 0.98), and have worse self-rated health (OR 0.80-0.87).

Other patient viewpoints included: 

  • I didn't want the provider to think I'm a difficult patient (51 and 38 percent)
  • I didn't want to take up any more of the provider's time (45 and 36 percent)
  • I didn't think it mattered (39 and 33 percent)
  • I didn't want the provider to think I'm stupid (38 and 31 percent)
  • I didn't want this information in my medical record (34 and 31 percent).

The authors surmised that the electronic health records may worry some about what goes into their chart.

Withholding important information from their clinicians was most likely when patients disagreed with or misunderstood their clinician’s instructions. A better understanding is needed of patients comfort and fears if we are to improve clinician-patient relationship and patient care.

The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Does Methotrexate Work in Giant Cell Arteritis?

There seems to be both hope and uncertainty regarding the use of weekly methotrexate (MTX) in giant cell arteritis (GCA) patients whom need to limit their glucocorticoid use. While well done clinical trials have shown no certain efficacy, data suggesting MTX benefits comes from small trials, anecdotes and clinical experience. 

Price of Drug Promotion Skyrockets

JAMA reports that health care advertising costs in the U.S. have almost doubled over the past two decades, surging from $17.7 billion in 1997 to at least $29.9 billion in 2016. (Citation source:

2018 Rheumatology Year In Review

This annual appraisal of hallmark moments, news and research articles from 2018 are gleaned from that published in RheumNow during the last year and filtered by other news sources and literature review.  The top 10 list herein is rooted in what rheumatologists should know and what will likely change their standards and practice in the future, if not 2019. 

Best of 2018: Advance Practice Clinicians Proliferating in Specialty Practices

An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices.  By 2016, 28% of all specialty practices employed APCs.

Best of 2018: Patients May Not Fill Your Prescription

A new study linking administrative claims and electronic health records (EHRs) shows that nearly 40% of patients fill and take newly prescribed methotrexate (MTX), tofacitinib or biologics. 

Kan et al set out to estimate the extent and predictors of primary nonadherence in rheumatoid arthritis (RA) patients who received new prescriptions for methotrexate, biologics or tofacitinib.