Managing medications: Experience of empowered & engaged partners

Managing medications – the most frequent interaction between health team members – includes both the clinical aspects of our health journey and the behavior of health team members. Medication management that works depends on empowered, informed patients and their caregivers prepared for clinician visits, and engaged, collaborative clinicians skilled at working with activated patients. Unfortunately, current management is often haphazard, disorganized, time-consuming, and frustrating with a heavy dose of paternalism in complaints about lack of “patient adherence.” If managing medications worked better we could see better patient safety, improved health outcomes, and a positive impact on life flow and work flow. The challenge is so widespread and so fundamental. How can we systematically approach the opportunities in medication management to find the right tools and methods?C:\Users\Dvanleeu\AppData\Local\Temp\enhtmlclip\Image.gif

First we need a framework for analysis, then a list of relevant activities that would benefit from tools and methods, and finally, we need to recognize success. So jump in:
 
The opportunities in patient-centered medication management include:
  1. Accurate, up-to-date patient information
    1. Changes in demographics and insurance,
    2. comprehensive health team membership
  2. Informed patient
    1. Collaborate to set mutual medication goals,
    2. Create and maintain medication list and/or read and change portal information [including OTC],
    3. Able to disclose usage variation,
    4. Alert to and tracking medication outcome and side effects,
    5. Voice follow-up questions and concerns for clinician,
    6. Know where to seek information outside of clinical visit,
    7. Manage continuity of care among multiple clinicians);
  3. Engaged clinician
    1. Collaborate to set mutual medication goals,
    2. Manage patient/caregiver diversity including cognitive challenges,
    3. Provide links to information outside clinical visit,
    4. Able to disclose errors,
    5. Communicate with other clinicians in health team

The team could use tools and methods that help

1) Organize current medications on paper or electronically (patient)
2) Report on usage, outcome, and side effect (patient)
3) Prepare questions before conversations with clinician (patient)
4) Set mutual medication treatment goals (clinician and patient)
5) Manage differing styles of communication about medications (clinician and patient)
6) Seek further information after clinic visit (clinician and patient)
7) Disclosure of errors in prescribing or administering (clinician)
8) Communication with multiple clinicians for continuity and integration of care (clinician)
9) Management of care coordination with multiple clinicians (patient)
10) Integrate tools into life flow (patient) and work flow (clinician)
We could measure success if we see
  1. Increase in meeting mutual medication treatment goals
  2. Increase clinician confidence in communication with patients
  3. Increase patient confidence in communication with clinicians
  4. Maintain or improve life flow and work flow
  5. Improved health outcomes (individual and population

What do you think? Does this speak to you? What would you change? What would you prioritize? Who do you think cares about this?

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