Abstract
Purpose
A standardized medication plan for patients has been developed and recently enacted into German law depicting all medicines taken. It can only increase medication safety if patients use and understand it. We evaluated patients’ comprehensibility of the medication plan and analyzed potential variables influencing patients’ understanding.
Methods
The medication plan template v2.0 was first tested in N = 40 patients, and the “Evaluation Tool to test the handling of the Medication Plan” (ET-MP) was developed, rating patients’ understanding from 0 to 100 %. The cut-off, distinguishing if patients understand the medication plan, was set at 90 %. The ET-MP was then applied to an amended medication plan questioning N = 40 general internal medicine (GIM) and N = 50 patients with chronic heart failure (CHF).
Results
The mean (± standard deviation (SD)) age of the study cohort was 69 ± 13 years, 47 % female. Patients took 8 ± 3 drugs chronically. The CHF patients had a lower level of education compared to the GIM group (p = 0.004). The overall ET-MP score was 82 ± 21 % (GIM 86 ± 19 %, CHF 78 ± 23 %; p = 0.16). Forty-three percent achieved a score >90 %. A moderate correlation was found between the ET-MP score and the level of education (r = 0.45) and age (r = −0.46), respectively (both p < 0.001). Cognitively impaired CHF patients (p = 0.03) and patients with advanced CHF (p = 0.006) achieved a lower ET-MP score. In the CHF cohort, signs of depression or a lower level of self-care behaviour were not associated with a lower ET-MP score.
Conclusion
The ET-MP is suitable to explore patients’ understanding of a medication plan. Less than 50 % of the patients reached a score above 90 %. Higher age and lower level of education but not the diagnosis of CHF seem to correlate with impaired understanding of the standardized medication plan. In addition to a medication plan, a significant number of patients are in need of further and continuous care to improve medication safety.
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Acknowledgments
We thank the participating community pharmacies for their support in recruiting study participants. We acknowledge the contributions of Maike Petersen, Sophie Bronkow and Saskia Koslowski, pharmacy students at the Freie Universitaet Berlin, for conducting interviews in the main investigation.
Contribution of the authors
Contributors: LB substantially contributed to the conception and design of the study, recruitment and data collection of the pilot and GIM patients, overall data analyses and writing of the manuscript. KM substantially contributed in the recruitment, data collection and analyses of the CHF patients. KK, CE and MS contributed to the conception and design of the study as well as writing the manuscript. AW and UL contributed in the recruitment and data collection of CHF patients. CK and UL contributed to the conception and design of the study. All authors contributed in critically revising the manuscript.
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The authors declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Funding
The pilot study was funded by the German Federal Ministry of Health as part of the PRIMA project (Primärsystem-Integration des Medikationsplans mit Akzeptanzuntersuchung, ref. no. 2514ATS001).
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Botermann, L., Monzel, K., Krueger, K. et al. Evaluating patients’ comprehensibility of a standardized medication plan. Eur J Clin Pharmacol 72, 1229–1237 (2016). https://doi.org/10.1007/s00228-016-2082-5
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DOI: https://doi.org/10.1007/s00228-016-2082-5