Medication Therapy Tools Help Pharmacists Educate Patients, Improve Adherence and Safety

AHRQ’s Health Literacy Tools for Providers of Medication Therapy Management make it easier for pharmacists to help patients understand and correctly manage their medications. These tools have boosted patient safety for more than 50 million patients receiving pharmacy services from SinfoníaRx annually.

Established in 2006 at the University of Arizona College of Pharmacy, the company provides a range of medication management services, including those for patients with Medicare Part D. During 2016, SinfoníaRx completed more than 1.1 million interventions and saved nearly $243 million in estimated health care costs as a result of their work assisting patients with their medication needs.

Medication therapy management is a personalized service designed to boost health outcomes for each patient. Pharmacists work directly with patients, their medical providers, and community pharmacists to ensure optimal treatment while reducing the risk of adverse events and drug interactions.

A widespread problem underlying many medication problems is that the information that comes with prescriptions is not understood by most adults in the United States. That’s where the AHRQ tools can be helpful.

AHRQ tools are incorporated into all of SinfoniaRx's training and call script materials. For example, all staff members are trained to assess for health literacy and to use simple, clear instructions and language when speaking with patients. The company's clinical call scripts include the teach-back method, adherence counseling techniques derived from AHRQ tools, open-ended questions, and strategies to address language barriers.

Sandra Leal, PharmD, MPH, chief operating officer at SinfoníaRx, said, “AHRQ’s tools allow pharmacists to address issues and improve health literacy, making the most of their limited time with patients. Busy pharmacists can find what they need in one consolidated resource. There are manuals for pill cards, templates to use, and guidance for patients who are struggling to afford medications.”

While SinfoníaRx primarily works with clinical call centers providing medication therapy management from four national sites, the company also works to establish integrated clinical pharmacy services in a variety of settings. These include a hospital discharge program, integrated behavioral health clinics, accountable care organizations, and patient-centered medical homes. Telehealth and other strategies help provide resources to communities, clinicians, and patients.

Patients talk by phone with a pharmacist to address their personal needs. The teach-back method—where patients repeat back in their own words how they are going to take their medication—can be particularly useful to pharmacists as they counsel patients. This helps in the transition-of-care program to assess, intervene, and address any gaps in the patient’s knowledge of their condition, according to Jenny Bingham, PharmD, transition of care coordinator.

Talking to patients about their medication can have a significant impact on their health. “Pharmacists are an integral component during the transition-of-care period 30 days after hospital discharge,” Bingham said. Examples of how she has helped patients include the following:

• A woman who was experiencing chest pain, headaches, heart palpitations, fast heart rates, and lower back pain told Bingham that she was afraid to call her doctor. Bingham explained the possible ramifications if the patient did not seek emergency medical attention for her cardiac symptoms and persuaded the patient to call her provider. The doctor sent the woman to the hospital. The next day, Bingham learned that the patient was administered an antiarrhythmic in the emergency department for tachycardia. Bingham contacted the woman’s outpatient cardiologist and scheduled an immediate follow-up appointment.
• A patient with asthma was struggling to pay her $400 copay for two types of medications. Bingham reviewed cost-saving alternatives with the patient for a medication that combined the benefits of both inhalers into one.
• Bingham called a patient with a history of heart attack and stroke who admitted that her blood pressure was extremely elevated and that she had awoken with a splitting headache. The patient had gone to the emergency room, but left after waiting 4 hours without being seen. Bingham called back later and asked the patient to recheck her blood pressure. It was still elevated, so Bingham advised her to go back to the hospital. She refused. Bingham called the woman’s doctor, who convinced the patient to seek emergency help and come in for a follow-up appointment.