Medication Self-Management Education for Patients

Grant Application

Amy L. Seybert, PharmD, FASHP, FCCP, CHSE, James Coons, PharmD, BCPS, Sandra Kane-Gill, PharmD, MS, FCCM, FACCP, Solomon M. Adams, PharmD, Kim C. Coley, PharmD, FCCP, UPMC Presbyterian Units 3E, 3F, 4D, 5

Proposed Innovation

Evidence shows that patients who share in treatment decisions are more likely to adhere to their regimens. This innovative project was designed to incorporate shared decision making into the new UPMC Pharmacy Care Model through the use of tools for assessment of adherence, medication self management, and medication access/affordability.

Improvements

Twenty pharmacists and pharmacy students were trained to incorporate Shared Decision Making (SDM) strategies into their patient assessments and interventions. They used decision aids — such as medication education sheets, pillboxes, and electronic medication reminder alerts — to improve medication adherence. Mobile devices facilitated patient assessment and the SDM process. Patients were asked to answer a questionnaire covering the four areas that impact medication-taking behaviors: beliefs, adherence, affordability, and adverse effects. The results of the survey were used to identify medication adherence problems and guide the SDM process.

Outcomes

The pharmacy team evaluated 173 patients with a mean age of 61 years, who were on an average of nine medications each. The survey showed that: 14% of patients were not sure they needed medications to treat their health problems; 22% were not able to take their medications as prescribed; 20% experienced side effects from their medications; and 20% found it difficult to pay for their medications. The pharmacy team reviewed shared goals with patients and developed a plan, when appropriate. Additionally 26% of patients were provided with written medication education and 13% were provided with a medication adherence tool.

An assessment on the program’s impact on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores showed positive results. The pharmacy practice model now supports routine access to discharge prescriptions through the UPMC Presbyterian Prescription Shop.