States News Service
April 15, 2014
More than 60% of adults in the United States older than 65 years take at least five medications each week; 15% take at least 10, according to the Agency for Healthcare Research and Quality (AHRQ). It's not surprising, then, to learn that patients in this age group are more likely than younger individuals to have a medication error and adverse drug event.
One way to help increase medication adherence is to help engage patients as a partner in medication safety. This can be done in various ways, but one shown to be effective is a medication list.
"An up-to-date medication list provides real-time information to health care providers at the point of both prescribing and dispensing to support informed, shared decision making about adding an additional medicine to a patients' existing medicine regimen," said Deborah Davidson, Membership Director for the National Council on Patient Information and Education (NCPIE). "It also creates an opportunity to conduct a medicine checkup to ensure that duplicate or unnecessary medicines are not being taken."
A 2007 study conducted by AHRQ in Walworth County, WI, found that creating a partnership among providers and patients helped improve medication accuracy and increase self-management.
The study included five clinics with patients aged 55 years and older. Patients in more than 80 educational programs were given more than 16,000 paper medication lists and nearly 8,000 bags to transport medication to and from physician visits.
The study measured the rate of accurate medication lists in the clinics compared with those in a group of control clinics. The authors found that the rate of accuracy increased from 55% to 72%, a rate much greater than that in the control group. The medication list was found to be the preferred self-management tool by both patients and providers.
What you can do
Pharmacists were an important component in the AHRQ study. They can educate patients on creating and maintaining a medication list. As with any other educational campaign, contact with patients is integral.
There are a few important things to discuss with patients when going over medication lists. Talk with them about the importance of keeping the list in their purse or wallet and taking it to every physician visit. Make sure patients understand the need to include vitamins, dietary supplements, and herbs they take. Let them know they can provide a copy for you to keep on file and another for a caregiver or family member who helps with medical decisions in case of an emergency.
Medication lists can also help patients and caregivers remember pertinent information about their prescriptions. Explain that an up-to-date list should include the following:
- How and when the medication should be taken
- How long it will be taken
- How long it might take the medication to work
- Any tests that might be required to take with the medication (e.g., kidney function)
- Potential adverse effects
- Food, drinks, or other medications to avoid when taking a medication
- If a medication has specific storage requirements
- Refill dates
- Medications to which a patient is allergic
- The proper dosage of medications, particularly OTCs such as NSAIDs
- The name of the physician who prescribed the medication
NCPIE offers a comprehensive checklist, Make Notes and Take Notes, that you or a physician can review with patients to create a medication list (http://apha.us/1kN2coc).
The websites listed in the box at the top of the page offer medication lists that you can download and provide to patients or post in your pharmacy.
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