Lea Botermann1,2, Katharina Monzel3, Katrin Krueger1, Christiane Eickhoff1, Angelika Wachter3, Charlotte Kloft2, Ulrich Laufs3, Martin Schulz4,5,6. 1. Department of Medicine, ABDA-Federal Union of German Associations of Pharmacists, Unter den Linden 19-23, 10117, Berlin, Germany. 2. Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany. 3. Department of Internal Medicine III-Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg/Saar, Germany. 4. Department of Medicine, ABDA-Federal Union of German Associations of Pharmacists, Unter den Linden 19-23, 10117, Berlin, Germany. m.schulz@abda.de. 5. Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany. m.schulz@abda.de. 6. Drug Commission of German Pharmacists (AMK), Berlin, Germany. m.schulz@abda.de.
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.
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 CHFpatients 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 CHFpatients (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.
Authors: Florentine Carow; Karin Rieger; Ingeborg Walter-Sack; Markus R Meyer; Frank T Peters; Hans H Maurer; Walter E Haefeli Journal: Eur J Clin Pharmacol Date: 2012-02-22 Impact factor: 2.953
Authors: Alexander F J Send; Adel Al-Ayyash; Sabrina Schecher; Gottfried Rudofsky; Ulrike Klein; Matthias Schaier; Markus G Pruszydlo; Diana Witticke; Kristina Lohmann; Jens Kaltschmidt; Walter E Haefeli; Hanna M Seidling Journal: Br J Clin Pharmacol Date: 2013-09 Impact factor: 4.335
Authors: J A Gazmararian; D W Baker; M V Williams; R M Parker; T L Scott; D C Green; S N Fehrenbach; J Ren; J P Koplan Journal: JAMA Date: 1999-02-10 Impact factor: 56.272
Authors: Stefanie Amelung; Bianca Bender; Andreas Meid; Stefanie Walk-Fritz; Torsten Hoppe-Tichy; Walter E Haefeli; Hanna M Seidling Journal: Dtsch Med Wochenschr Date: 2020-10-06 Impact factor: 0.628