Enhancing communication to prevent medication-related harm
Medication use among Iowans is rising dramatically, as more new drugs are
quickly approved for marketing and the advent of Medicare Part D gives
most senior citizens in our state prescription drug coverage.
While medications can be a cost-effective
healthcare treatment, when used inappropriately
they may result in patient harm and unnecessary
healthcare costs. Studies show up to 40 percent of
patients do not take their medications as prescribed,
and a 76 percent discrepancy was found between
instructions for medication use
and how the medication was
actually taken.1,2 Applying these
statistics to Iowans over age 18
indicates nearly one million
of our citizens don't take their
medications as prescribed.
With grant funds provided
by The Wellmark Foundation,
the Iowa Healthcare
Collaborative is working to
increase health literacy among
Iowans, giving consumers
confidence to seek care when they need it, and
equipping them to provide information needed for
the best possible health outcomes. Communication
between patients and providers about medication use
significantly impacts treatment success or failure,
and IHC is spearheading efforts to enhance patientprovider
communication through distribution of a
simple yet very valuable tool called the MedCard.
IHC launched a collaborative one-year campaign
to promote recognition and use of the MedCard
in September 2007. Based on a prototype from a
successful "Medication Matters" program initiated
by St. Luke's Hospital and Mercy Medical Center
in Cedar Rapids, the MedCard is an easy-to-use
tool for healthcare consumers to maintain and use
when communicating about medications with their
healthcare providers.
The MedCard is simply an information sheet
folded inside a billfold-sized plastic sleeve that can
also store the individual's health insurance card. The
sheet provides instructions and an easy-to-use format
for individuals to record the name, purpose, dosage
and instructions of their medications.
Our goal is to distribute 150,000 MedCards
and 2,000 MedCard starter kits to Iowa patients
and providers by September 2008. We'll evaluate
the effectiveness of these tools through patient and
provider surveys, keeping our eye on our ultimate
purpose-better health outcomes for Iowans.
"Medication Matters" for Cedar Rapids hospitals and residents
Two Cedar Rapids hospitals, St. Luke's Hospital and Mercy
Medical Center, recognized patients' need to keep a complete,
accurate record of their health information. In 2003, they teamed up
to develop the "Medication Matters" program, an initiative to prevent
medication mishaps.
The hospitals worked to develop the free wallet-sized cards and
distribute them at both hospitals as part of the discharge process,
as well as through local doctor's offices and pharmacies. The first
year, 150,000 Medication Matters cards were distributed, and 50,000
additional cards are distributed each year. St. Luke's and Mercy also
developed and implemented medication reconciliation processes
throughout all inpatient areas.
Dr. Anthony Carter, an emergency room physician at
St. Luke's, says the cards are very helpful in providing safe
and effective care. "I always thank people who have the card
when they come in," he says. "When certain medications
are combined that shouldn't be, it can cause toxicity in the
patient. Knowing what medications the person is taking
avoids this danger."
"To me it is invaluable-it keeps me organized," says
Cedar Rapids resident Roxanne Augustine. "I always pull the
sheet out when I am at the doctor's office or St. Luke's, and
they usually just photocopy it. It saves a lot of time in completing
my medical history," she says.
Augustine's complex medical history includes approximately
18 different medical diagnoses, 30 allergies, several prescription
and over-the-counter medications, and multiple surgeries. She maintains all this
information on her Medication Matters card, making sure to update it whenever she has
a change. When she has too many changes, she picks up a new card at St. Luke's
or her doctor's office.
Augustine was diagnosed with multiple sclerosis (MS) in 1996, and the disease
has had far-reaching effects on her overall health. Today, she says, "I take 17 to 20 pills
per day. My MS causes short-term memory loss, and I have to write everything down.
It doesn't take that much time to update my card."
But for preventing medication-related harm, maintaining a Medication Matters card
is time well spent.
