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Research has shown that patients often have difficulty knowing how and when to take their medicines, especially if their regimes are complex. Patients with limited health literacy tend to have particular difficulty taking medicines accurately. Helping patients understand and remember what medicines they need and how to take them can reduce errors.
Ask patients how they remember to take their medicines.
You might say:
- "Everyone forgets to take their medicine from time to time. When was the last time you forgot to take any of your medicine?"
- "Do you have a way of remembering to take your medicines?
Provide patients with a list of medicines.
- You can edit the following documents to provide patients with simple documentation of what medicine to take and when to take it.
- If you have an EHR, explore whether it can produce a medicine list that patients can easily understand.
Anticipate and prevent errors.
- Consider purchasing online reminder tools. There are a number of commercially available tools that include features like:
- Lists of patient medicines and simple explanations of what each medicine is for.
- Audiovisual tutorials to help patients learn how to take their medicines.
- Email or text messages to remind patients to take their medicines and to refill their prescriptions.
- Always write prescriptions that include precise instructions for taking the medicine. For example, instead of writing "twice daily" write, "Take 1 pill in the morning and 1 pill at bedtime." Use the evidence-based instructions for taking pills, which can be installed in your EHR for eprescribing. The instructions are also available in Chinese, Korean, Russian, Spanish, and Vietnamese. Include a plain language description of what the prescription is for (e.g., "for high blood pressure").
- Warn patients about possible changes in the color, shape, and size of pills. Make patients aware that color, shape, and size of pills may change when they refill prescriptions. Reassure them that, as long as the name of the medicine and the dose are the same as what they are used to taking, their medicine will work the same way and should be taken as originally directed.
Make it easy.
- Provide pill boxes. Teach patients and caregivers how to fill a pill box using their medicine list as a guide.
- Enlist help from family members. Family members can play an important role in reminding patients to take medicines and/or setting up and filling pill boxes.
- Advertise ways you can help. Tell patients that you can help them set up reminder strategies, such as pill boxes and medicine lists. Hang the Help with Medicine Poster in your exam room or waiting rooms.
- Synchronize refills. Whenever possible, set up refills for multiple medicines so they occur at the same time of the month.
- Document reminder strategies. Make sure patients' reminder strategies are documented in their medical record. If you have an EHR, coordinate across the practice so everyone documents reminder strategies in the same location, one that you can query.
Before starting and again 2 weeks after implementation, identify the percentage of patients who had a medicine reminder strategy documented in their medical record. Use your EHR or examine a sample of medical records for 20 patients who regularly take medicines and were seen in the last week. Check again in 2, 6, and 12 months to see how consistently your clinicians are helping patients set up and documenting medicine reminder systems.
If you field questions from the Health Literacy Patient Survey, calculate what percentage of patients responded "Always" to question #19.