Low-health literacy flashcards & mobile video reinforcement to improve medication adherence in patients on oral diabetes, heart failure, and hypertension medications

详细信息    查看全文

• 作者：Denise L. Yeung ; ^{denise.yeung@phhs.org}Author Vitae ; Kristin S. AlvarezAuthor Vitae ; Marissa E. QuinonesAuthor Vitae ; Christopher A. ClarkAuthor Vitae ; George H. OliverAuthor Vitae ; Carlos A. AlvarezAuthor Vitae ; Adeola O. JaiyeolaAuthor Vitae
• 刊名：Journal of the American Pharmacists Association
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：57
• 期：1
• 页码：30-37
• 全文大小：324 K
• 卷排序：57

文摘

To design and investigate a pharmacist-run intervention using low health literacy flashcards and a smartphone-activated quick response (QR) barcoded educational flashcard video to increase medication adherence and disease state understanding.DesignProspective, matched, quasi-experimental design.SettingCounty health system in Dallas, Texas.ParticipantsSixty-eight primary care patients prescribed targeted heart failure, hypertension, and diabetes medicationsInterventionLow health literacy medication and disease specific flashcards, which were also available as QR-coded online videos, were designed for the intervention patients. The following validated health literacy tools were conducted: Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy Medicine–Short Form, and Short Assessment of Health Literacy–50.Main outcome measuresThe primary outcome was the difference in medication adherence at 180 days after pharmacist intervention compared with the control group, who were matched on the basis of comorbid conditions, targeted medications, and medication class. Medication adherence was measured using a modified Pharmacy Quality Alliance proportion of days covered (PDC) calculation. Secondary outcomes included 90-day PDC, improvement of greater than 25% in baseline PDC, and final PDC greater than 80%. Linear regression was performed to evaluate the effect of potential confounders on the primary outcome.ResultsOf the 34 patients receiving the intervention, a majority of patients scored a high possibility of limited health literacy on the NVS tool (91.2%). The medication with the least adherence at baseline was metformin, followed by angiotensin-converting enzyme inhibitors and beta blockers. At 180 days after intervention, patients in the intervention group had higher PDCs compared with their matched controls (71% vs. 44%; P = 0.0069).ConclusionThe use of flashcards and QR-coded prescription bottles for medication and disease state education is an innovative way of improving adherence to diabetes, hypertension, and heart failure medications in a low–health literacy patient population.