Managing patients' medications effectively

As the number of patients with chronic diseases grows, medication optimization is as important as ever to improve outcomes, decrease costs, and improve quality of life. Treatment plans involve medications 80% of the time, affecting almost every aspect of a patient's life. Adherence can be difficult for patients to achieve. Implementing a team-based medication plan is vital for adequate drug therapy.

There are several steps to take to ensure patients are managing their medications for optimal outcomes.

Partner with patients to determine a current medication list and medication management processes. Review patients' medications to minimize adverse reactions, maximize effectiveness, and ensure that desired health outcomes are achieved. Ask questions about patients' medication-taking behavior to help modify their care plans.

Evaluate patients' full medication list in light of their current health status to assess each medication's indication, effectiveness, and safety. Collect important patient-specific health information, and assess patients' medical records to ensure they are getting maximum efficacy and safety from the medications they are taking.

Assess patients' barriers to appropriate medication use. Determine patients' health literacy, screen for social needs, and develop a referral service and educational materials to help the practice identify barriers.

Tailor the educational approach to individual patients and their situations. Provide patient- and caregiver-friendly education and medication management support materials in a variety of languages and formats.

Provide patients with an updated medication list at each clinic visit. Make sure it has clear instructions for each medication as well as reasons for use.

Collaborate with pharmacists to capitalize on their expertise. Offer pharmacist-provided comprehensive medication management services within the practice to provide medication optimization and allow clinicians to spend more time on other tasks.

There are also options for practices to implement workflows and systems to help the clinical team and patients manage medications.

A practice sees many patients on a regular basis, and managing medication lists can be burdensome. It is important to incorporate medicine reconciliation into the patient visit. A nonphysician member of the team can review patients' medications at the beginning of their visits. The physician can use this conversation to learn what medications patients are taking and create a list of their current medications and update it as necessary. The physician can also ask patients to bring their medications to the appointment or, if using telehealth, ask them to show their medications so the team can assess what they are taking. This method minimizes discrepancies among members of patients' health care teams and gets them the medication they need. If the office uses electronic health records (EHRs), then the physician may be able to automatically run daily reports on medications and mark any that are about to expire.

It may sometimes be beneficial to assign caregivers, especially to patients with chronic conditions or those who are elderly. Assigned caregivers could be anyone from a family member to a professional who knows the patient's medical history: someone who can obtain the medication for the patient, make sure the patient is taking the correct medications, monitor side effects, and contact the clinical care team when needed.

Transparency is key when managing medications. Therefore, the caregiver and physician should have an honest conversation about what medications, vitamins, or supplements the patient is taking. Giving caregivers a document they complete to record patients' medication lists helps them understand the care plan.

Adding technology into the practice can also help reduce medication errors. EHRs or other practice management software programs often manage prescriptions automatically, sending prescription refills to the pharmacy and offering patient portals where patients can access their records and request a refill online.

Adopting technology into a practice can be challenging for physicians and for staff. It is important to choose a system that is intuitive to the entire clinical team. Physicians can also use an app to incorporate automatic texting or messaging services to remind patients to take their medications and at what dosage. Whichever type of HIPAA-compliant technology a physician chooses to incorporate, it is vital to the clinical care team and patients to learn how to use it correctly.

To learn more about improving medication management, visit ACP Practice Advisor's Comprehensive Medication Management module. It is approved for Maintenance of Certification and continuing medical education.