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GREENSBORO - Comparing the way people of different races and incomes get prescriptions may sound like an obscure bit of research.

But in Greensboro, that study has been a pilot program for a National Institutes of Health research project that will distribute tens of millions of dollars nationwide.

That larger study seeks to identify how factors such as race, sex, income, insurance status and language may interfere with people getting the health care they need. Such factors are thought to contribute to higher disease and death rates among some minority groups.

The agency wants researchers to find ways to improve communication with patients and spread those methods quickly, said Dr. Sam Cykert , chief of the internal medicine teaching program at Moses Cone Hospital.

"Our physicians are doing their best to provide quality care to an increasingly diverse population, under tight time and resource constraints, in an increasingly complex health care environment," said Deborah Young , clinical coordinator with the UNC-Chapel Hill Translational and Clinical Sciences Institute .

The research, she said, will highlight ways to better serve and treat that diverse population.

In addition to Cone and the UNC-CH medical school, the Greensboro Health Disparities Collaborative is taking part in the program. That group is researching why minorities with health conditions, insurance status, age and income similar to those of white people still often are less healthy.

The Greensboro study, called the Respectful Prescribing Study , is a first step toward understanding whether and how communication with a patient is a factor, Young said.

Between September and May, the researchers convened six focus groups totaling about 70 patients of different races, genders and insurance status.

"We wanted to know what was important to patients about getting prescriptions," Young said. "We asked if they felt they were treated differently based on insurance, race and gender."

Gina Hansen of Greensboro , a patient at the Moses Cone Family Practice Center , participated in a focus group in April .

She said participants were asked general questions about how well they thought they communicated with their doctors and more specific questions about whether they thought they were being fully informed and given options with regard to prescriptions.

"(The moderator asked) 'Did certain medications make you feel ill? Did they work? If they didn't work, how (quick) were you in getting back to your doctor? Did you get the proper dose? How often did you stop taking your medications, and did you tell your doctor?'" Hansen recalled.

Researchers found that all the focus-group participants wanted more information about the reason for a prescription, possible side effects and costs versus benefits.

But researchers also found:

* Caucasian patients were more likely to want to share decision-making and negotiate treatment with their doctors.

* African Americans wanted more attention to basic elements such as physical exams and patient histories. They also wanted to ensure the patient understood the doctor and that the doctor understood any barriers a patient might face in following a course of treatment.

* African Americans were more likely to think that doctors were "overprescribing."

* African Americans were more likely to perceive generic drugs as inferior to brand names. As a result, Young said, African American patients are more likely to stop taking their medications because they aren't sure the drugs will work well.

Cykert said addressing these problems will mean doctors will have to take more time with patients. But he thinks they'll be willing to do so once they're informed about the issues.

The researchers will ask focus-group members for their ideas for workable solutions.

Ultimately, Cykert said, the larger National Institutes of Health program will seek ways to streamline communication and interaction among basic scientists, clinical researchers and community physicians so that findings are shared more quickly among them.

It also will find ways to allow communities to tell researchers what research is most important to them, Cykert said.

For Hansen, the experience accomplished a bit of what researchers hope the whole project will accomplish.

"I'm kind of feeling a little bit better about expressing myself in the medical community, standing up for myself where medical issues are concerned, being a little more inquisitive about medications," she said.

"I felt like this is something very important for people to know ... that somebody hears you, you know?"

Contact Lex Alexander at 373-7088 or lex.alexander@news-record.com