Abstract
Introduction: Assisting patients to regain independence in medication management is an integral part of rehabilitation pharmacist care. A structured self-administration of medication program (SAMP) is needed as an objective measure of patients’ ability to self-manage medication and support patient-centred care.
Aim: To assess and improve rehabilitation patients’ ability to self-manage medications using SAMP and provide further support for unsuccessful patients.
Method: An assessment tool was developed to identify eligible patients. SAMP consisted of four stages: (1) initial pharmacist counselling with use of medication list, (2) supervised self-administration, (3) independent self-administration and (4) patient-to-pharmacist teach-back assessment. A Drug Regimen Unassisted Grading Scale (DRUGS) was used to assess patients’ understanding of medication. A validated Medication Regimen Complexity Index (MRCI) was used to assess change in complexity of medication regimen.
Results: The program had a high success rate with 14 out of 20 participants successfully completing the SAMP. The mean age of participants was 74.4 years. The participants were self-administering a mean of 6.1 medications on admission and 10.4 on discharge, with a mean increase in MRCI of 45%. Successful SAMP participants demonstrated a mean change in DRUGS score from 90.6% to 98.4%. Seventy-eight percent of successful participants reported increased confidence. Two patients self-withdrew. Most importantly, SAMP identified 4 patients as unable to safely self-administer giving the pharmacist opportunity to arrange alternative medication management.
Conclusion: SAMP improved patients’ understanding and ability to self-manage medications. Furthermore, it enabled objective assessment of patients’ capacity to manage their medications aiding decision making for discharge planning.