Table 3.

Selected examples of observed knowledge gaps.

a)Patients and informal caregivers lack knowledge A 65 year-old White male states, “So they got me, they put me on this, I forget the name of the drug I take…And they got me on, uh, Spironolactone, which is a, it’s something for your heart, I don’t know.” A 79 year-old Afro-Caribbean male describes experiencing multiple symptoms of worsening heart failure and fluid retention, but was reluctant to take an extra diuretic medication because he perceived there was nothing wrong with his heart. The daughter of a 74 year-old White female states, “I didn’t recognize it as heart either when you swelled up. I thought it was gout.”

b)Clinicians lack knowledge about patients’ medication-related behavior An 81 year-old White male patient describes not taking diuretics when he travels but that he “never really discussed it” with his physician. A 65 year-old Black female adjusts the frequency of her medication without consulting her doctor: “I have to take it twice a day, it’s supposed to be three times, I take it twice a day.” A nurse and 71 year-old Black male attempt to communicate about a medication. Nurse: “Um, using your sp-, in-, Spiriva inhaler?” Patient: “Yeah.” Nurse: “How many times a day?” Patient: “Tha-, that’s blue, ain’t it?” Nurse: “I don’t know.” Patient: “I got, I got inhaler, I got one … use it sometimes.” Nurse: “Just when you need it?” Patient: “Yeah, only though, not like the blue one all the time. What you call it?” Nurse: “I don’t know. I don’t, I don’t know what those look like.”

c)Patients/caregivers and clinicians represent medication-related knowledge differently A cardiologist attempts to identify which prescribed medication a 65 year-old Black female patient is taking. Cardiologist: “So mom says she needs Sedia and Bumax and something else, but she doesn’t know which one.” Patient: “Maximillistine, I can’t say it, you know.” Cardiologist: “Well, it’s Maxaltine, but you’re not on that.” Patient: “I, well, it’s the pill, I’m on it, but I…” Cardiologist: “I don’t know which one, you know.” Patient: “--its M, it’s uh, I can’t say it…it’s, it’s a, I have to take it twice a day, it’s supposed to be three times, I take it twice a day. It’s orange and kind of brown.”