Contending mediated risk messages: A grounded theory of the physician-patient discussion of a prescription medication's changing risk

Objective: This study investigated the process and message strategies physicians use to communicate the changing risk of medication to patients with chronic medical conditions. The study purposes were to identify mediated messages' effects on the risk discussion and to develop a model of the changing risk communication process. Methods: Using a grounded theory approach, this study systematically analyzed physician reports of clinic risk communication to explain how the process occurs inductively. Results: Overall, physicians described an intermediate model of the patient-physician relationship, identifying two types of patients. The communicatively active patient talked to salient others about and scanned media for health information and recognized when known risks of the medication have changed. The communicatively non-active patient may have passive exposure to health information but did not recognize known risks have changed. Physicians reported a difference in medical discussions with communicatively active patients compared to communicatively non-active patients. Conclusion: Theory generated here includes media exposure as a critical influence in the clinical risk discussion and the physician's response to those mediated messages as a distinguishing characteristic. Practice implications: A practical application of this generated theory is how it can be used to address the potential barriers of communicating about medication risk.