Medication management is a patient-focused approach to helping patients take their medicines properly and consistently refill their prescriptions. Implementing a medication management program can improve patient outcomes, reduce unnecessary visits to the emergency room or hospital, and reduce the negative effects or even death that can result when patients don’t take medication properly.
Here are eight medication management activities that can help patients stick to their medication regimens and stay well. To optimize effectiveness, each activity should be included in a provider organization’s medication management program. If you are looking to implement such a program, the Agency for Healthcare Research and Quality (AHRQ) offers a QuickStart Guide along with a number of handouts, training material, and templates.
1. Ask patients to bring all of their medications with them to the visit.
This is often referred to as a “brown bag” review because patients are told to put all of their pill bottles, supplements, herbs, and over the counter medications into a brown bag and bring it to the appointment. Essential for new patient visits, but also important for established patients, this review enables clinical staff and physicians to list all medications and dosages and make sure that each is recorded in the patient’s medication list in the electronic health record (EHR). Further, “taking inventory” of all the patient’s medications is the first step in a proper medication reconciliation process.
2. Remind patients to bring their medications when you remind them of their appointment.
Some practices do this by phone. Others use text messaging or emails. Still others mail a postcard. Whichever method is used, remind patients to bring all of their medications to the appointment, in addition to reminding them about the day and time.
3. Provide patients a current medication list at the end of each visit.
It’s important that patients and their families have a list of every medication the patient is taking, the dosage and frequency, and the reason they are taking it. Once the staff have conducted the “brown bag” review, entered the information into the EHR, and the physician prescribes or discontinues a medication(s) during the visit, this list should be updated as part of medication reconciliation, and provided to the patient before he or she leaves the office.
4. Explain the benefits of pharmacy “pill packs,” and provide a list of options.
“Pill packs” are a service available from multiple companies and pharmacies, and can really aid patients in organizing and taking their pills properly.
Essentially, the patient buys their medicines in pre-made packs, rolls or sheets, organized by day. All they need to do is take the day’s pills, which are prepared and organized for them. Many services even deliver. Pill Pack, for example (now owned by Amazon), ships medications every two weeks and can contact the physician's office to confirm the medication schedule and coordinate refills. It also has a companion mobile device app that patients can use to remind them to take their pills throughout the day.
Make it easy for patients to sign up for a “pill pack” service by creating a handout that lists pharmacies and other companies that offer the service, and how to sign up.
5. Suggest that patients use an automated, pill reminder app.
There are hundreds of pill reminder apps in the Apple and Android app stores. Simply put, patients load in their medications, along with the dosages, frequency, and times they should take them. The app rings or beeps when it’s time for the patient to take the pill. By entering the number of pills they have on hand, most apps can also remind patients when a refill is needed.
Mango Health, Medisafe, and Dosecast are just a few examples of reminder apps. All are available for free in the Apple or Android app store.
6. Encourage patients to use a medication synchronization service.
Medication synchronization is a great convenience to patients who have multiple prescriptions or multiple providers who add or remove medicines from their regimen. With this service, a pharmacist coordinates refills so they can all be picked up on a single day each month. Medication synchronization eliminates the need for patients or their family members calling in multiple refills or making multiple trips to the pharmacy - both of which can contribute to missed pills.
7. Distribute and display a patient fact sheet in the office.
Raising and maintaining awareness about the importance of taking medications properly is a good way to keep it in the forefront of a patient and family member’s mind. Providing a fact sheet to all patients is one way to increase awareness.
The sheet should explain the purpose of developing a complete and accurate medication list, the role of the patient and family member, and the importance of the medication list. The AHRQ has developed a 1-page fact sheet that can be handed to patients or posted on office walls.
8. Train the staff.
It’s easy to overlook this step when things get busy. But training is essential for making sure that all patients receive a consistent message and all staff perform the steps in your medication management program completely and correctly.
Provide guidance to all staff about how to talk with patients and families about why taking prescribed medicines properly is so important. Scripts can be very helpful to ensuring staff say the same thing, and do so with compassion and without judgement.
Train the clinical staff how to complete the medication list, as well as explain the importance of using a reminder app and the value of pill pack services. The AHRQ developed a written process for each step of medication management, which can be used as a foundation for training as well as developing a standard procedure. This useful AHRQ Webinar on Medication Management Strategies walks through the process, as well as offers training tips.