Health Literacy/Medication Adherence and Medication History/Reconciliation

Question 1

What is the definition of adherence?

Answer 1

The extent in which a person’s behaviors corresponds with agreed recommendations from a health care provider.

e.g extent in which patients take medications prescribed

Question 2

What is the medication adherence percentage?

Answer 2

Anything greater than or equal to 80%

Medical Adherence percentage =
((#pills absent in time x)/(#pills prescribed for time x)) *100

Question 3

Answer 3

1) (90-23)/90 *100 = 74% Not adherent for Cozaar

2) (90-7)/90 *100 = 92% adherent for Microzide

Question 4

What is medication non-adherence?

Answer 4

Intentional or inadvertent failure to take medication as prescribed.

e.g Not filling prescriptions, never taking meds, missing dose, inappropriate usage of medication

Question 5

Why is health literacy an important process of medication adherence?

Answer 5

Health literacy allows patients to better understand their illness and manage their illness therefore increasing adherence. There is a positive and statistically significant relation between literacy and adherence.

Question 6

What is personal health literacy?

Answer 6

The degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others

Question 7

What is organizational health literacy?

Answer 7

The degree to which organizations equitably enable individuals to find understand and use information and services to inform health-related devisions and actions for themselves and others

Question 8

What are the contextual factors of health literacy?

Answer 8

Reading skills, culture, writing skill, speaking skills, listening skills, numeracy skills, conceptual knowledge,

Question 9

Who does limited health literacy affect?

Answer 9

-Mfs aged 65 and older
-Chronically ill
-Disabled
-Economically disadvantaged
-Individuals with low english proficiency

Question 10

What does limited health literacy cause?

Answer 10

Delayed diagnoses, increased medication errors, non-adherence, hospital readmissions, increased health care cost, decrease disease state understanding

Question 11

Red flags for low literacy?

Answer 11

Frequently missed appointments, incomplete registration forms, non compliance, unable to name medication, identifies pills by looking at them and not reading the label

Question 12

What is medication history?

Answer 12

Used to gather relevant information about patient’s medication use

Elements of medication history = Patient information, Allergies, Health care services, Medications

Question 13

What is an example of patient information?

Answer 13

Demographic Information (Always use 2 identifiers):
-Name
-DOB
-MRN
-Gender
-Room Number

Question 14

What is an example of Health care services in medication history?

Answer 14

-Preferred pharmacy
-Insurance
-Other facilities: Hospitals and nursing facilities

Question 15

What is an example of Allergy in medication history?

Answer 15

-Drug and food allergies
-Review the patient chart
-If they had a previous allergic reaction:
“How long ago?”
“Ask symptoms of reaction”
“Ask treatment of reaction”
“Name of the agent”
“The dosage if possible”

Question 16

What is an example of medications in medication history? (This question kinda dumb tbh but deal with it lolz)

Answer 16

-Current prescription medications (Special formulations like inhalers, injections, suspensions, powders, and sprays)
-OTCs like acetaminophen, aspirin, topicals
-Herbal and dietary supplements like iron, calcium, probiotics, fish oil, etc.

Question 17

When verifying a medication what should we do?

Answer 17

If an antibiotic ask: What are we treating, Duration of antibiotic, and complete # of days

For each medication we verify the name, dose, frequency, and indication

We ask when the last dose was: Morning, Noon, Evening? Yesterday, last month, last week?

Question 18

What are some common errors in medication history?

Answer 18

-Incorrect dose, frequency, strength, name, dosage form
-Omission of therapy
-Therapy with no indication

Question 19

What are some tips and tricks to be successful when dealing with medication history?

Answer 19

-Open ended questions
-Rephrase and give clues
-Use reliable resources like family and friends

Question 20

What is medication reconciliation according to join commission?

Answer 20

Medication reconciliation is the process of comparing a patient’s medication orders to all of the medications that the patient has been taking.

Question 21

What is medication reconciliation according to centers for medicare and medicaid services?

Answer 21

The process of identifying the most accurate list of all medications that the patient is taking, including name, dosage, frequency, and route, by comparing the medical record to an external list of medications obtained from a patient, hospital or other provider.

Question 22

What are the steps to complete medication reconciliation?

Answer 22

1) Obtain as accurate of home medication history list
2) Reconcile medication list to inpatient medication list
3) Using your professional judgement to make clinical decisions on what medication to order for the patient
4) Educate patient and caregivers on most updated medication list upon discharge

Question 23

What is IESC (Iguana Eats Snow Cone)?

Answer 23

-Indication
-Efficacy
-Safety
-Convenience

Question 24

How do medical reconciliation and history go hand and hand?

Answer 24

You should be able to collect medication history from different resources and accurately use them in order to execute medication reconciliation.