Improving oncology patient medication knowledge through a systematic medication reconciliation process.

Abstract

354 Background: Patient medication knowledge improves medication adherence. Lack of medication adherence leads to 125,000 deaths per year and $100-$299 billion in cost to the U.S. health care system. An Oncology Advanced Practice Provider (APP) conducted a quality improvement (QI) project to evaluate the effect of an educational review of medications to improve oncology patients’ knowledge regarding medication use. Methods: A QI project consisting of 60 patients seen during their regularly scheduled office visits was conducted. Patients received verbal instructions and written documentation about their medications; prescribed and over-the-counter. Evaluations were conducted and yes/no responses were recorded based on patients’ ability to answer four questions correctly: name of medication, reason for the medication, dosing schedule, and prescriber’s name. This was followed by a second visit using the same process. Results: Participants ranged in age from 42-87 (median = 67); most participants were female (N = 36), Caucasian (N = 37), and retired (N = 31). The total number of medications taken by the participants equaled 174, of which 130 were prescribed and 44 were over the counter medications or supplements. The most common prescribed medications were antiemetics (ondansetron and prochlorperazine) and pain medications (hydrocodone and oxycodone). Other prescribed medications included steroids, antihypertensives, and antiglycemics. The most common over the counter medications were Aspirin, Vitamin D, and multiple vitamins. A total of 612 Medication Reviews were completed. Of these reviews, on Visit I (Initial visit) 274 Educational reviews were required. On Visit II (post educational review) 169 Educational reviews were required. Patients needed 105 fewer educational reviews after the initial educational review. The average time between visits was two weeks. An unexpected finding was the lack of a complete and accurate record of medications taken by the participants as documented in their medical records. Conclusions: An Oncology APP led medication reconciliation process including an educational review showed improved medication knowledge among participants, although more than one review may be needed by some patients. Findings confirm the need for a systematic, comprehensive medication profile in the electronic medical record (EMR) to avoid medication errors in both administration and prescribing. An annual review of medications with patients is critical to their well-being.