[Patient anxiety and expectations surrounding the use of medication]

Patients who take prescription drugs are thought to feel both "anxiety" and "expectations" surrounding medication use. Anxiety is felt regarding medication effectiveness, side effects, and potential dependency, and is believed to impact medication adherence, which declines to less than 50% after six months. A good therapeutic relationship between patients and physicians, which allows discussion of such topics as side effects, or the duration of ongoing medication use, is required to relieve patient anxiety, but doctor-patient communication usually does not meet patients' expectations: A discrepancy exists between what clinicians report they communicate to patients, and patients' perceptions of what they were told. At the same time, patients also maintain positive expectations for change induced by pharmacotherapy. These expectations can be inferred to be closely related to the placebo effect, which is reported to account for 30% of overall therapeutic effect. However, at the beginning of treatment, few patients are seeking pharmacotherapy; rather, they hope to share their worries with physicians, or talk about the difficulties of their illness with therapists. Physicians must therefore work to understand patients' treatment preferences, and should make initial treatment decisions only after sharing information and thoroughly consulting with patients.