Medication Knowledge Research Articles

A Pharmacist Education Initiative Apoteker Cilik to Improve Medication Safety Knowledge among Elementary School Students in Gresik, Indonesia

Pharmacists have the responsibility to ensure that medicines are obtained, used, stored, and disposed in the best and safest way particularly by a vulnerable population such as children. Pharmacists should adapt to a child’s level of health understanding to engage children in medication education. Therefore, a pharmacist-led program tailored to children in community settings was initiated in two elementary schools in Gresik, SD Muhammadiyah 1 Gresik and SD Muhammadiyah Manyar. An animated film Apoteker Cilik was shown to students of grade 4, 5, and 6 to promote the proper management of medications in line with the national campaign DAGUSIBU and to acquaint with the roles of pharmacists. A short questionnaire consisting of six questions related to medication use and safety (how to get, use, store, and dispose medicines) was utilized to assess the level of children’s knowledge. There was a significant difference between levels of knowledge before and after the program (p < 0.05) although some schoolchildren already had good baseline knowledge of medications. This local initiative may contribute to improving medication awareness, so more educational programs using colourful visuals and interactive games may be conducted with this vulnerable population as children will bring their medication-taking behaviour throughout their adult lives.

Effects of a nurse-led medication self-management intervention on medication adherence and health outcomes in older people with multimorbidity: A randomised controlled trial

BackgroundOlder people with multimorbidity are usually required to manage multiple medications and complex medication regimens. However, clinical guidelines for medication management almost entirely focus on a single disease. Further research is needed to assess the efficacy of medication self-management interventions for older people with multimorbidity. ObjectiveThis study aimed to evaluate the effectiveness of a nurse-led medication self-management intervention on medication adherence and health outcomes in older people with multimorbidity. DesignA single-blind, two-arm randomised controlled trial. SettingsThree community health centres in Changsha, China. ParticipantsOlder people with multimorbidity. MethodsA total of 136 participants were recruited and randomly allocated into either a 6-week nurse-led medication self-management intervention group (n = 67) or usual care group (n = 69). The intervention consisted of three one-on-one educational sessions on medication-related information, motivation and self-management skills and two follow-up phone calls. The primary outcome was medication adherence. Secondary outcomes included medication self-management capacity, treatment experiences, quality of life and utilisation of health care services. Outcomes were measured at baseline, post-intervention and 3-month follow-up. The intervention effects were assessed using generalised estimating equation models. ResultsStatistically significant improvements were found in medication adherence (β = 1.63, p = 0.034), medication knowledge (β = 2.61, p < 0.001), beliefs about harm of medication (β = −1.83, p < 0.001), medication self-efficacy (β = 3.22, p < 0.001) and satisfaction with convenience of medication use (β = 5.02, p = 0.005) for the intervention group compared with the control group immediately post-intervention. Compared with the control group at 3 months follow-up, the intervention group demonstrated significantly greater improvements in medication knowledge (β = 2.26, p < 0.001), beliefs about necessity of medication (β = 2.68, p = 0.002) and concerns about medication (β = −2.44, p = 0.002), medication self-efficacy (β = 1.87, p = 0.015) and medication burden (β = −3.96, p = 0.004). Improved medication adherence was observed in the intervention group at 3 months follow-up compared with baseline, although the differences between the groups were not significant. No statistically significant effects were found on quality of life and utilisation of health care services at either time point. ConclusionsA 6-week medication self-management intervention significantly improved medication adherence immediately post-intervention, suggesting a short-term intervention effect. A longer intervention period and continuous follow-up support may be required to achieve sustained improvements in medication adherence and health outcomes in older people with multimorbidity. RegistrationChiCTR.org.cn (ChiCTR2000030011); Start of recruitment: June 2020.

Transition to adult services: the current and potential role of the UK hospital pharmacist

PurposeTo explore the current and potential role for UK pharmacists in the transition to adult services for young people with chronic health problems.MethodsUK hospital pharmacists were surveyed using an online...

Medication Knowledge and Adherence in Type 2 Diabetes Mellitus Patients in Brunei Darussalam: A Pioneer Study in Brunei Darussalam.

Aim: The present study measured the medication knowledge and medication adherence in patients with type 2 diabetes in Brunei Darussalam. Demographic details and diabetes knowledge were also evaluated. Methods: A cross-sectional study conducted via the administration of a structured questionnaire consisting of 4 sections via a face-to-face interview. Results: A total of 118 participants were interviewed. A majority of the participants were aged 40 years or above (106, 89.8%). The mean number of total medications that the participants were taking was 7.36 ± 2.87 and the mean number of antidiabetic medications was 2.39 ± 1.06. As for the antidiabetic therapy, the largest proportion of the participants were taking oral antidiabetic medications only (87, 73.73%). In the diabetes knowledge section of the questionnaire, more than half of the participants (63, 53.34%) scored higher than the acquired mean score. Family history, education level, and total medications taken were significantly correlated with diabetes knowledge. However, in the medication knowledge section of the questionnaire, the mean score (3.37 ± 1.38) was below the intended score for good knowledge. Medication knowledge has been significantly associated with gender, family history and total medications taken. A majority of the participants reported non-adherence (74, 62.71%) due to various reasons. In this study, those of the Malay race were significantly correlated with adherence to their medication regimen. This study also revealed that there is no significant relationship between diabetes knowledge, medication knowledge and medication adherence. Conclusions: The present study provides insights in regard to patients with type 2 diabetes in Brunei Darussalam and their knowledge towards the disease as well as their medications. Despite the lack of significance between the variables, the rate of non-adherence is still alarming. Further studies are required to better understand the barriers to non-adherence in these patients.

Antibiotic prescription errors: the relationship with clinical competence in junior medical residents

BackgroundA large portion of prescribing errors can be attributed to deficiencies in medication knowledge. These errors are preventable and most often occur at the time of prescription. Antimicrobials are the drug class most common incorrectly prescribed.ObjectiveTo characterize the relationship between clinical competence and antibiotic prescription errors. We also investigated the frequency and severity of antibiotic prescription errors to identify items and attributes of clinical competence which are correlated with the antibiotic prescription error ratio.MethodA cross-sectional study was applied to assess clinical competence of junior medical residents in two reference academic hospitals and a regional hospital in Mexico City. It was conducted during February 2019. We used an infectious disease Objective Structured Clinical Examination (OSCE) to assess clinical competence and a measure of frequency, and severity of antibiotic prescription errors.ResultsThe number of eligible participants was ~ 255 (hospital meeting attendance), and the number of residents in this study were 51 (~ 20%), 31 were female (60.8%). The mean OSCE score was 0.692 ± 0.073. The inter-item (Cronbach’s alpha = 0.927) and inter-station internal consistency was adequate (Cronbach’s alpha = 0.774). The G coefficient in generalizability theory analysis was 0.84. The antibiotic prescription error ratio was 45.1% ± 7%. The most frequent category of severity of antibiotic prescription errors was category E (errors that may contribute to or result in temporary harm to the patient and require intervention), 235 (65.2%). We observed a negative and significant correlation between clinical competence and antibiotic prescription errors (r = -0.33, p < 0.05, CI95% -0.57 to -0.07), which remained significant after controlling for the effect of gender and time since graduation from medical school (r = -0.39, p < 0.01, CI95% -0.625 to -0.118). Using exploratory factor analysis we identified two factors, which explained 69% of the variance in clinical competence, factor 1 evaluated socio-clinical skills and factor 2 evaluated diagnostic-therapeutic skills. Factor 2 was correlated with antibiotic prescription error ratio (r = -0.536, p < 0.001).ConclusionsWe observed a negative correlation between clinical competence and antibiotic prescription error ratio in graduated physicians who have been accepted in a medical specialty. The therapeutic plan, which is a component of the clinical competence score, and the prescription skills had a negative correlation with antibiotic prescription errors. The most frequent errors in antibiotic prescriptions would require a second intervention.

The impact of a comprehensive pharmaceutical care intervention in addition to cardiac rehabilitation program on outcomes of post-acute coronary syndrome patients: A pilot study

ObjectiveTo test the efficacy of Comprehensive pharmaceutical care intervention added to cardiac rehabilitation program(CR programs) in improving echocardiographic parameters, nutritional status and High sensitivity C-Reactive Protein(hs-CRP), in post-acute coronary syndrome patients. MethodsA prospective; randomized, controlled study. 40 post-acute coronary syndrome patients, participating in CR program, were randomly allocated to either the control group(n = 20) or the intervention group(n = 20). Pharmaceutical care intervention included face-to-face education about the disease, healthy lifestyle, medication adherence, drug related problems management and goal setting. hs-CRP and cardiac parameters were measured at baseline and after 3 months. ResultsAfter three months,the intervention group showed a significant decrease in left ventricular end systolic volume (p = 0.0026) and left ventricular end diastolic volume (p = 0.0009) compared to the control group. Also, intervention group showed a significant increase in nutritional status (p = 0.037) and the patients' knowledge about the disease and drugs (p = 0.0001). However, there was no significant change in hscrp level between groups. ConclusionOur findings indicate that Comprehensive pharmaceutical care intervention added to CR programs significantly improved cardiac parameters and nutritional status. This is best explained by increasing adherence to cardiovascular medications and to healthier lifestyle and optimizing medication knowledge and doses. Practice implicationsImplementing Comprehensive pharmaceutical care intervention added to CR programs could improve the cardiac function and nutritional status of post-acute coronary syndrome patients.

Impact of a pharmaceutical care service for patients with rheumatoid arthritis using a customised mobile device (the PROUD trial): study protocol for a randomised controlled trial

IntroductionRheumatoid arthritis (RA) generally requires lifelong treatment; however, its medication complexity might affect non-adherence. Pharmacist-led telehealth services were as effective as face-to-face services and reduced potential side effects in outpatients...

Medication Adherence Rate in Arab Patients With Cardiovascular Disease: A Systematic Review.

Cardiovascular disease (CVD) is one of the most common chronic illnesses in the Eastern Mediterranean. There have been few studies on medication adherence in Arab patients with CVD. To investigate the rates and the reasons for medication adherence in Arab patients with CVD. The Joanna Briggs Institute methodology for prevalence systematic reviews was used. MEDLINE, EMCARE, CINAHL, Scopus, Science Direct, PsychINFO, and the Cochrane Central Register of Controlled Trials were searched. Thirteen quantitative studies on medication adherence in Arab adult CVD patients were included.Pooled data from nine studies demonstrated that 53.2% (95% confidence interval = [51.2%, 55.1%]) of patients were adherent to their medications. Reasons for nonadherence to medication include personal factors, understanding, and complexity of treatment regimes, medication knowledge and structural barriers. Medication adherence appears to have a social gradient, and families should be actively involved in future strategies to increase medication adherence.

A Survey of Speech-Language Pathologists' Use of Patient Medication Information for Patients With Dysphagia

Purpose: Medications can produce side effects that negatively impact swallowing and cognition. Speech-language pathologists (SLPs) who know which medications their patients are taking are able to consider the potential impact of medication side effects on their patient's swallow function and progress in therapy. The goal of this investigation was to gain preliminary information on how often SLPs report that they review a patient's medications as part of their standard practice, as well as the most common reasons for not reviewing patient medications. Method: A 10-item online questionnaire was distributed to practicing SLPs to collect information regarding their clinical experience, patient caseload, and whether they routinely review patient medications. Logistic regression analysis was used to determine which variables were associated with medication review. Results: Responses were received from 205 SLPs. Approximately half reported “always” reviewing patient medications ( n = 116). The most frequent reason given for not reviewing medications was lack of pharmacology training. The results indicated that SLPs with 15 years or more of experience were nearly 3 times more likely to review medications than SLPs with less experience. Not all Special Interest Groups participated in the distribution of the survey. Conclusions: Many SLPs reported that they did not consistently check patient medications as part of a patient evaluation. Of concern is the possibility that SLPs do not realize the importance of medication knowledge. Clinicians may gain familiarity with the medications and understanding of the impact that medications have on their patients as they accrue clinical experience. Future research should investigate the best ways to promote knowledge of this topic in new clinicians.

Nurses’ knowledge and understanding of obstacles encountered them when administering resuscitation medications: a cross-sectional study from Palestine

BackgroundMedication errors (ME) are one of the most important reasons for patient morbidity and mortality, but insufficient drug knowledge among nurses is considered a major factor in drug administration errors. Furthermore, the complex and stressful systems surrounding resuscitation events increase nursing errors.AimsThis study aimed to assess the knowledge about resuscitation medications and understand the obstacles faced by nurses when giving resuscitation medications. Additionally, errors in the reporting of resuscitation medication administration and the reasons that prevented nurses from reporting errors were investigated.MethodsA cross-sectional study was conducted in the West Bank, Palestine. Convenient sampling was used to collect data, which was collected via a face-to-face interview questionnaire taken from a previous study. The questionnaire consisted of five parts: demographic data, knowledge of resuscitation medications (20 true/false questions), self-evaluation and causes behind not reporting ME, with suggestions to decrease ME.ResultsA total of 200 nurses participated in the study. Nurses were found to have insufficient knowledge about resuscitation medications (58.6%). A high knowledge score was associated with male nurses, those working in the general ward, the cardiac care unit (CCU), the intensive care unit (ICU) and the general ward. The main obstacles nurses faced when administering resuscitation medication were the chaotic environment in cardiopulmonary resuscitation (62%), the unavailability of pharmacists for a whole day (61%), and different medications that look alike in the packaging (61%). Most nurses (70.5%) hoped to gain additional training. In our study, we found no compatibility in the definition of ME between nurses and hospitals (43.5%).ConclusionsNurses had insufficient knowledge of resuscitation medications. One of the obstacles nurses faced was that pharmacists should appropriately arrange medications, and nurses wanted continuous learning and additional training about resuscitation medications to decrease ME.

Abstract 273: Prescription Rate For Antihyperglycemic Medication With Proven Cvd Benefit At Discharge In Stroke Patients Not Equal Among Payer Sources

Mortality doubles in stroke patient with diabetes mellitus (DM). Target: Type 2 DiabetesSM (TT2DM) is an American Heart Association (AHA) initiative focused on providing evidence-based guideline (EBG) resources to mitigate risk in hospitalized stroke patients with DM. Get With The Guidelines® (GWTG)- Stroke hospitals track EBG data to improve patient outcomes. TT2DM initiative is comprised of 10 EBG data elements related to stroke and DM subpopulation. The measure Antihyperglycemic Medication with Proven CVD Benefit at Discharge in Stroke Patients with DM has low compliance. Methods: GWTG®-Stroke DM reports reviewed from January 1, 2020-June 30, 2021, from 50 Wisconsin Coverdell Stroke Program hospitals. Analysis of 2554 patients with primary diagnosis of stroke with history of or newly identified DM during hospitalization were in the denominator. Numerator met when patients were prescribed GLP-1 Receptor Agonist or SGLT-2 Inhibitor at discharge. Measure compliance was further delineated according to payment source documented. Patient payer source was identified as: Self-Pay, Medicaid, Medicare, and Private. Findings: In specified timeframe, 7.9% of patients received Antihyperglycemic Medication with Proven CVD Benefit at Discharge. Compliance variation exists across payer source. Differences in compliance rates were 2.2% Self-Pay, 6.4% for Medicare, 7.7% Medicaid, and 12.1% for Private. Conclusions: Discharge prescription rate for antihyperglycemic medication with proven CVD benefit at discharge in stroke patients has low compliance, further variation exists among payor sources. Items for consideration are higher cost of medication and thus payor status are driving factors in prescribing rates. Additional barriers may exist as discharge clinicians may not feel DM management is their responsibility, there may be a medication knowledge gap. Providing EBC requires shared decision making among patients and clinicians to ensure proper follow up. Engaging a multidisciplinary approach at discharge to verify insurance coverage, alternate cost options, and follow up needs may enhance compliance. Future considerations are to assess race “within” payor source to gauge if there is disparate care.

Benefits of, Barriers to, and Needs for an Artificial Intelligence-Powered Medication Information Voice Chatbot for Older Adults: Interview Study With Geriatrics Experts.

BackgroundOne of the most complicated medical needs of older adults is managing their complex medication regimens. However, the use of technology to aid older adults in this endeavor is impeded by the fact that their technological capabilities are lower than those of much of the rest of the population. What is needed to help manage medications is a technology that seamlessly integrates within their comfort levels, such as artificial intelligence agents.ObjectiveThis study aimed to assess the benefits, barriers, and information needs that can be provided by an artificial intelligence–powered medication information voice chatbot for older adults.MethodsA total of 8 semistructured interviews were conducted with geriatrics experts. All interviews were audio-recorded and transcribed. Each interview was coded by 2 investigators (2 among ML, PR, METR, and KR) using a semiopen coding method for qualitative analysis, and reconciliation was performed by a third investigator. All codes were organized into the benefit/nonbenefit, barrier/nonbarrier, and need categories. Iterative recoding and member checking were performed until convergence was reached for all interviews.ResultsThe greatest benefits of a medication information voice-based chatbot would be helping to overcome the vision and dexterity hurdles experienced by most older adults, as it uses voice-based technology. It also helps to increase older adults’ medication knowledge and adherence and supports their overall health. The main barriers were technology familiarity and cost, especially in lower socioeconomic older adults, as well as security and privacy concerns. It was noted however that technology familiarity was not an insurmountable barrier for older adults aged 65 to 75 years, who mostly owned smartphones, whereas older adults aged >75 years may have never been major users of technology in the first place. The most important needs were to be usable, to help patients with reminders, and to provide information on medication side effects and use instructions.ConclusionsOur needs analysis results derived from expert interviews clarify that a voice-based chatbot could be beneficial in improving adherence and overall health if it is built to serve the many medication information needs of older adults, such as reminders and instructions. However, the chatbot must be usable and affordable for its widespread use.

Dental students' knowledge of and attitudes towards prescribing medication in Western Australia.

Dentists can prescribe medications for prophylactic and therapeutic purposes. In Australia, dental graduates can autonomously practise within the scope of their qualifications without needing to undertake an internship post-graduation. Although previous research has identified knowledge gaps amongst dental students in Australia on pharmacology and pharmacotherapeutic knowledge, there has been no published research that qualitatively highlights dental students' knowledge of medication prescribing in Australia. This study aimed to undertake a qualitative analysis of Western Australian dental students' attitudes towards and knowledge of medication prescribing. This qualitative case study design employed semi-structured interviews as means of collecting data. It utilised a purposive sampling in penultimate and final year dental students at the University of Western Australia. Twenty dental students participated in the study. Five key themes were identified in the data: current and previous education, application when delivering pharmacology and pharmacotherapeutics, teaching to ensure patient-centred care, supervision and referral to relevant resources. Participants agreed that having previous knowledge in the area provides students with confidence regarding medication prescribing. Furthermore, students in this study valued having guidance when prescribing medications. This study highlights the complexity of medication prescribing for dental students. It also highlights their experience with the current pharmacology and pharmacotherapeutics curriculum. All students interviewed valued application-based teaching, making it specific to dentistry. If curriculum were to be redeveloped, considering their perceptions may be a valuable tool.

Medication Self-Management in Hospitalised Patients with Schizophrenia or Bipolar Disorder: The Perceptions of Patients and Healthcare Providers.

Aim(s): The aim of the study was to explore perspectives of hospitalised patients with schizophrenia or a bipolar disorder and their healthcare providers on medication self-management. Methods: In a qualitative descriptive design, semi-structured interviews were used. Forty-nine interviews were completed (nurses n = 18; psychiatrists n = 3; hospital pharmacists n = 2; patients n = 26). Data analysis was iterative using an inductive and thematic approach. Results: From the thematic analysis of the interviews, three main themes emerged: monitoring and shared decision-making, relationship based on trust, and patient satisfaction and rehabilitation; as well as three sub-themes: available tools, patient readiness, and safety. Regular monitoring and follow-ups were considered conditions for medication self-management. All stakeholders considered that the patient, the nursing staff, and the psychiatrist should all be involved in the process of medication self-management. All healthcare providers emphasized the importance of regular re-evaluations of the patient and were worried about medication errors and misuse. Most patients considered medication self-management during hospitalisation to increase their confidence, self-reliance, and satisfaction. Many participants thought it would make a positive contribution to the recovery process. Discussion: All stakeholders were positive towards medication self-management under specific conditions. According to the participants, medication self-management offered many benefits, including the implementation of more structure for the patient, an ameliorated preparatory phase towards discharge, and an actual improvement of future adherence. All participants considered medication self-management to contribute to more profound medication knowledge and an overall improvement of their health literacy. Implications and future perspectives: These findings will be used to develop a medication self-management tool in hospitalised patients with schizophrenia or bipolar disorders.

An exploratory study of outpatient medication knowledge and satisfaction with medication counselling at selected hospital pharmacies in Northwestern Nigeria.

Medication counselling is an important activity that improves patient therapeutic outcomes. After this activity has been carried out, patients should be satisfied with counselling, and possess adequate knowledge about their medications. To describe outpatient/caregiver medication knowledge and satisfaction with medication counselling at the main outpatient pharmacies of eight public secondary and tertiary hospitals located in two states in Northwestern Nigeria. Exit interviews were conducted from December 2019 to March 2020 with randomly sampled patients/caregivers who had just been dispensed one or more prescription medications from the main pharmacies of the hospitals. The questionnaire used contained 31 questions in three sections. The first section collected demographic information. The second section assessed respondents' experiences and overall satisfaction with the counselling they had received. The last section evaluated respondents' knowledge of one randomly selected prescription medication that had been dispensed to them. Data collected were coded and analyzed to generate descriptive statistics. To explore associations between respondent characteristics and overall satisfaction, non-parametric tests were used, and statistical significance set at p<0.05. A total of 684 patients/caregivers were interviewed. Majority of respondents agreed that the time spent (97.1%) and quantity of information (99.1%) provided during counselling was adequate. However, over 60% of them also agreed that dispensers did not assess their understanding of information provided or invite them to ask questions. Despite this, their average overall satisfaction with counselling on a 10-point scale was 8.6 ± 1.6. Over 90% of them also correctly identified the routes and frequency of administration of the prescribed medication selected for the knowledge assessment. Although, more than 60% of respondents did not know the duration of therapy or names of these medications. Respondents' satisfaction with medication counselling was fairly high even though they did not seem to know much about their medication.

Use of a Medication Questionnaire to Identify Lung Transplant Recipients Benefiting from Pharmacist Prioritization in Clinic

<h3>Purpose</h3> Transplant pharmacist (TXP PharmD) presence in the clinic can improve patient medication knowledge retention, minimize adverse effects, decrease the need for hospital readmission, and ultimately improve outcomes. However, TXP PharmD to patient ratio in high volume clinics can range from 1 PharmD: 15-30 patients/day. Identification of patients most likely to benefit from seeing a TXP PharmD in clinic can aid in prospective interventions. <h3>Methods</h3> Beginning in 2018, questionnaires assessing medication knowledge retention were distributed to all lung transplant recipients (LTRs) during their clinic appointments. Within 1y post-transplant, all LTRs follow-up in clinic at months 1, 2, 3, 4, 5, 6, 8, 10, and 12. Questionnaires completed within 1y post-lung transplant (LT) were collated and responses graded. Variables associated with a greater total number of incorrect responses were analyzed including patient characteristics, index LT admission data, and time post-LT. <h3>Results</h3> Between 2018-2020, 404 medication questionnaires were completed within 1y post-LT. 152 LTRs completed 1 questionnaire and 113 LTRs completed ≥2. Medication retention was lowest (i.e. greatest total number of incorrect responses) at 11 months post-LT (p=0.048). Multivariable analysis of all 152 LTRs identified time post-LT, increasing age (p=0.047), and Black race (p=0.02) as associated with lower medication retention. In the 113 LTRs who completed ≥2 questionnaires, Black race (p=0.02) and location other than home pre-LT (rehab/skilled nursing facility/long-term acute care/inpatient, p=0.04) were associated with lower retention. <h3>Conclusion</h3> Pairing prospective identification of LTRs at risk for lower medication knowledge retention with assessment of patient-specific courses may allow TXP PharmDs to improve efficiency in a high volume lung clinic. Future studies should focus on the most useful types of interventions to help improve deficits in medication knowledge.

Evaluation of opioid disposal process for home hospice patients.

Context: Considering the national opioid epidemic and its impact on thousands of lives, the importance of appropriate management of controlled substances in the home hospice setting is paramount. Family members tend to be the primary caregivers for home hospice patients, and hospice nurses are the front line for providing education on opioid disposal. As such, the importance of effective and consistent education is essential in minimizing the risks of misuse and diversion. Objectives: To evaluate the use of a standardized opioid disposal policy through the implementation of three steps: (1) opioid education at enrollment in hospice program; (2) the use of the Medication Diversion or Misuse checklist; and (3) a review of the standards for safe opioid disposal. We also evaluated the current knowledge and understanding of the standard processes of opioid education and disposal among home hospice nurses. Study Design: Mixed methods. Setting or Dataset: Retrospective data and survey data, Milwaukee, WI; 07-12/2019. Population Study: Home hospice patients, home hospice registered nurses. Outcome Measures: The fidelity of our institution's opioid medication disposal policy and knowledge of the policy. Basic descriptive statistics were used to describe the patients and survey responses. Results: A total of 160 patients met inclusion criteria. We found that 108 (67.9%) patients/families received education on admission, 11 (6.9%) families received education on opioid disposal at the time of death, and 152 (95.6%) of families had an opioid disposal discussion at the death certification visit. Of the 16 nursing survey respondents, only 3 (18.8%) consistently provided all of the necessary education to new patients. However, when education is provided, 14 (87.5%) respondents did provide all the appropriate instructions regarding dosing, administration, side effects, and storage. On death calls/visits, 13 (81.2%) reported consistently providing the appropriate education regarding opioid disposal. Conclusion: Our results suggests that nursing staff do provide the appropriate education regarding the use and administration of opioids, as well as appropriate disposal practices, but do not do so consistently. The project highlighted the importance of continued nursing education regarding safe opioid use, disposal, and awareness of drug diversions.

The effect of Patient\u2019s Own Medication use on patient\u2019s self-reported medication knowledge during hospitalisation: a pre-post intervention study

BackgroundImproving patient’s medication knowledge and consequently medication use is essential for optimal treatment outcomes. As patient knowledge about medication is currently suboptimal, interventions to optimise medication knowledge are necessary. Implementation of Patient’s Own Medication (POM) in which patients bring their outpatient medication to the hospital, and nurses administer these during admission, may increase medication knowledge. The aim of this study is to explore the impact of POM use on self-reported medication knowledge of hospitalised patients compared to standard care. Patient’s sense of medication safety, attitude to the provision of information, and to inpatient medication use were studied in both standard care and during POM use too.MethodIn this nationwide intervention study perceived medication knowledge was assessed with a questionnaire pre and post implementing POM use. The questionnaire assessed perceived medication knowledge at admission and discharge, medication safety during hospitalisation, the provision of information during hospitalisation and at discharge, and inpatient medication use during hospitalisation. Patients’ answers were categorised into positive and negative/neutral. The proportion of patients with adequate medication knowledge, in the standard care and POM use group at hospital admission and discharge, were calculated and compared with adjustment for potential confounders.ResultsAmong the 731 patients (393 received standard care and 338 POM) who completed the questionnaire (80.2%), POM use seemed to be positively associated with self-reported knowledge on how to use medication at discharge (adjusted OR: 3.22 [95% CI 2.01–5.16]). However, for the other two knowledge related statements POM use was not associated. Medication knowledge at admission was the most important variable associated with perceived medication knowledge at discharge. The majority perceived POM use to be safer (52.9% of standard care patients versus 74.0% POM users; P < 0.01), POM users knew better which medicines they still used during hospitalisation (85.8% versus 92.3% resp.; P = 0.01), and most patients preferred POM use regardless of having experienced it (68.2% versus 82.2% resp.; P < 0.01).ConclusionPOM use positively affects patient’s medication knowledge about how to use medication and patients’ perception of medication safety. With POM use more patients have a positive attitude towards the provision of information. The majority of patients prefer POM use. In conclusion, POM use seems a valuable intervention and requires further investigation.

Nurse-Filled versus Pharmacy-Filled Medication Organization Devices—Survey on Current Practices and Views of Home Care Nursing Services

Medication organization devices (MODs) are widely used among home care nursing services. However, current practices such as the responsibility for filling MODs, different MOD types used and requirements of home care nursing services are largely unknown. The study aimed at analyzing home care nursing services’ current practices regarding MOD use, investigating their requirements and determining whether different practices met these requirements. A survey was administered online to German home care nursing services in February 2021. The importance of requirements and the extent of satisfaction were measured using a five-point scale. Attitudes towards disposable, pharmacy-filled MODs were recorded as free text. In total, 690 nursing services responded (67.5% privately owned and 34.5% based in large cities), 92.2% filled MODs themselves and used predominantly reusable, rigid MODs. Pharmacies filling MODs used primarily disposable MODs. Satisfaction with current practices was generally high. Respondents filling MODs themselves were more satisfied with nurses’ medication knowledge, but less satisfied with cost effectiveness than those who had pharmacies fill MODs. Of all respondents filling MODs themselves who expressed an opinion on disposable, pharmacy-filled MODs, 50.9% were skeptical, primarily due to fear of losing flexibility. However, no difference in satisfaction with flexibility was found between respondents filling MODs themselves and those using pharmacy-filled MODs. In conclusion, employment of MODs in the professional care setting is a complex task with nursing services as key constituents. There is potential for improvement in the inter-professional collaboration between pharmacies and home care nursing services on the use of MODs. Measures for improvement have to address home care nursing services’ requirements with respect to flexibility and medication knowledge.

School-based self-management intervention using theatre to improve asthma control in adolescents: a pilot cluster-randomised controlled trial

BackgroundChildren with poorly controlled asthma have higher rates of unplanned healthcare use and school absences, as well as lower rates of medication adherence and knowledge. They also feel less comfortable using their medication at school, due to social fears and bullying. In this study, this was addressed through two school-based self-management interventions piloted to determine which one to use in a full trial.MethodsWe sought to assess the feasibility and acceptability of two school-based self-management intervention aimed at improving asthma control. Schools in London were randomised to (i) a theatre workshop for the whole year group aimed at raising awareness of asthma in schools, followed by self-management workshops for children (full intervention), (ii) theatre workshop alone (theatre only), or (iii) usual care (controls). Opt-out consent was obtained from parents. The study was a cluster randomised pilot trial, using London schools as the unit of allocation. Our primary aim was to assess the feasibility of delivering a self-management intervention in schools aimed at improving the asthma control test (ACT) score at 6 months. Secondary outcomes included acceptability of the school-based interventions, suitability of the theatre intervention and the full intervention with the self-management workshops, and generation of randomised data to inform future power calculations. Data were analysed by generalised mixed-effect models.ResultsThe recruitment strategy for this trial was effective. Five schools were randomised to full intervention (189 children), four to theatre only (103 children), and six to controls (83 children). Asthma control test (ACT) score at baseline and 6 months was obtained from 178/358 participating children. Compared with the controls, there were no large differences found in ACT score with the full intervention; knowledge and perception of asthma improved though. GP and hospital visits increased in the full intervention group. Compared with controls, ACT score was unchanged in the theatre only group.ConclusionThe asthma self-management intervention trial in schools is feasible and acceptable. The full intervention consisting of both theatre and self-management workshop for asthmatics tended to be better suited to improve outcomes than the theatre intervention on its own. This full intervention should be the one carried forward into a main trial if funding for further research was sought. Further work is needed to understand why there was evidence that unscheduled visits to healthcare professionals increased with the full intervention.Trial registrationThe study was registered on the clinical trials database on 14th May 2018 (ID NCT03536416).