Adherence, Health Literacy & Medication Education

A study I just reviewed from the September, 2013 edition of the New England Journal of Internal Medicine shows that nearly 72% of patients picking up prescriptions have some sort of Health Literacy limitation.  (If you are unsure of what Health Literacy is, please review this article.)  Of those 72%, approximately half of the patients were not adherent to their medication regimen.   

Perhaps, just maybe, we need to take a closer look at how patients and caregivers receive their medication education. 

There are many venues in which patients receive medication education.  Some are better than others.  When receiving medication information we need to consider a few different items:

1.       What is the source of this information?
2.       Is the information being presented to me in a format that I can understand?
3.       Will I be able to refer back to this information whenever I need?
4.       How do I get my questions answered after reviewing the information is presented to me?

 Some of the methods that patients receive medication information are as follows:

·         Medication information is presented to the patient by the prescriber when the prescription is written.
o   Pros:  Patient is attentive and captive in the office.
o   Cons:  Patients usually forget what prescriber says soon after leaving the office.

·         Prescription counseling info presented to patient at pharmacy counter when picking up prescription:
o   Pros:  Pharmacist does the counseling and hopefully discusses all of the important information necessary.  Pharmacist also hands a drug information handout for follow up. 
o   Cons:  Sometimes pharmacist is busy and hurry’s through session.  Again, patient will regularly forget most of what the pharmacist says by time they get home. 

·         Drug Information Handout:
o   Pros:  These informational handouts are very complete.  Now and again I come across a patient who takes the time to read them front to back and they always call with questions.  This is ideal.
o   Cons:  These handouts are long, boring and cumbersome; rarely will a patient read them front to back and call with questions.

·         Drug information from an internet search:
o   Pros:  Information is right there, ready for your review.  Information is abundant and 1000’s of sources available.  Studies, evaluations, monographs, institutional sites as well as a never ending supply of personal testimonials.
o   Cons:  How in the world do you discern what is credible information.  You need to know and trust your source and you need to take the time to do appropriate research.

·         Friends telling you what to do:
o   Pros:  What could be better than following the advice of a friend?
o   Cons:  Really?  We are talking about your prescription medications here!

·         AudibleRx Web Membership or Android/IPhone  App:
o   Pros:  After having a consultation with your pharmacist at your community pharmacy, you then listen to a 6-8 Medication Specific Counseling Session.  After listening, you will have a clear idea of what you do and don’t know about your medication and be in a position to take educated questions back to your own pharmacist or doctor.
o   Cons:  You need to invest 6 minutes of your time to listen to the counseling session.

Regardless of your method of medication information, please take the time to follow through and do it.  Health Literacy is the concept that patients will understand their own basic health care knowledge.  Understanding your own medications; why you are taking them, what are the consequences of not treating, and where to go for more information are all important aspects of your own Health Literacy.

If you ever have a question about your medication, pick up the phone and call your community pharmacist.  If you don’t have a community pharmacist to contact, get one!  Mail-order prescriptions have done quite a bit to deter patients from having their consults with their own community pharmacist.  I encourage everyone to take a look at their program and see if it is possible to once again begin picking up their prescriptions from their local pharmacy.  When your community pharmacist is filling your prescriptions, the pharmacist is in a much better position to answer your medication related questions.

The above examples of how to receive medication information may all have a place in your education process; however, every patient needs a specific process for verifying and validating their information when they have questions.  Know your source, and know where you are going to call to get your questions answered.


Please take a moment to comment and tell us what your source for medication information is.

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