What do discharged patients know about their medication?
Introduction
During the last decade there has been growing awareness of the importance of patients’ counseling at discharge from hospital. Counseling thus provides the individual with the knowledge which will enable him/her to achieve an optimal state of health [1]. That is, with counseling, a patient can take an active role in achieving health, coping with illness, and managing treatment. Informed patients are more likely to comply with drug treatment programs [2], [3], [4], [5], may be less anxious, more secure, and better able to take charge of their own medication and treatment schedule [6], [7], [8], [9].
However, studies that have examined levels of knowledge about treatment among patients discharged from hospital have shown especially low levels of knowledge about medication therapy. Information about medication covers aspects, such as purpose of medication therapy, dosage, scheduling, side effects, and required lifestyle changes. Although, the majority of patients were found to be aware of the purpose of the medication [2], [10], [11], [12], lack of knowledge regarding side effects, tests and lifestyle changes was quite glaring. O’Connell and Johnson [12] found that only 27% of the patients were aware of possible side effects related to their medication. Other studies obtained similar results [5], [10], [13], [14], [15]. Some researchers have found a serious lack of knowledge regarding medication among patients discharged from hospital, including knowledge about dosages [10], [11], [13], [14], [16], [17]. For example, Lee et al. [18] surveyed 220 patients discharged to their homes from two medical-surgical units. They found that 40% of the patients needed more specified directions for care, such as how or when to take medications.
Gilhar and Levy [11] found that only a small percentage of patients were aware of the importance of taking their medication at the appointed times, the relationship with meals, and the necessity of taking medication for the prescribed period. Similarly, patients were not aware of the side effects that could develop as a result of their medication and some patients were not informed as to what should be done if these side effects appeared.
Researchers have also reported differences in knowledge of newly prescribed drugs and those prescribed before hospitalization. Patients who were discharged with instructions to continue their previous medication had better knowledge about their medication than did patients who had been prescribed new medications [11]. Yet, Pullar et al. [10] found no differences in patients’ knowledge of newly prescribed medications as opposed to those previously prescribed.
Having to take an increased number of medications has been shown to adversely affect patients’ knowledge and appropriate use of medications. The growing amount and complexity of knowledge required with the increase in medication can result in too much information for a patient to process and remember correctly [15], [19], [20].
The patient can obtain knowledge and information about medication therapy from several sources such as counseling, written information, the Internet and so forth. Physicians and pharmacists tend to be the main source of this information. An additional source for hospital patients is the nurse, who can fulfill an important role in preparing the patient for discharge and improving his/her self-care abilities with regard to medication management [21]. Other findings indicate that patients did not regard nurses as an important source of medication information [12]. However, most patients reported they had not been given opportunity to ask questions about medication by any members of the healthcare team [5], [17].
Successful patient education or counseling can be evaluated by measurable outcomes: knowledge, changes in attitudes, health behavior and compliance with medication therapy. The most common way to evaluate patient education is to estimate the patient’s knowledge and understanding of his/her medication therapy [22].
The purpose of this study was to assess Israeli patients’ reported knowledge about medication therapy after discharge from hospital and to compare this knowledge with correct information. Another purpose was to assess the correlation between correct knowledge of medication therapy, and characteristics of medication counseling and patients’ demographic variables.
Section snippets
Method
A cross-sectional survey was performed in six internal medicine wards at a large medical facility in Israel.
Participants
A total of 540 patients met the criteria for inclusion and agreed to take part in the study. Twenty patients (4%) refused to be interviewed a week after discharge, health status prevented 97 (18%) from being interviewed, 48 (9%) could not be located because of changes in address or telephone number, re-hospitalization, or transfer to a different care framework, and 34 (6%) were discharged without ongoing medication. All together 341 (63%) patients were interviewed.
The average age of the
Discussion and conclusions
This study illustrates the need for patient counseling during hospitalization, at discharge and within the community setting regarding medication therapy.
We found that only 40% of the patients received medication counseling during hospitalization. The fact that patients mentioned that they wanted more information on medication may indicate that the counseling given was not adequate. This finding has been also reported by other authors as well [13], [18]. Moreover, most patients preferred to
Acknowledgements
The study was supported by a grant from the Israel National Institute for Health Policy and Health Services Research (NIHP). We thank all nursing staff from the internal medicine departments for their help in recruiting participants and collecting data.
References (25)
- et al.
A systematic approach to educating elderly patients about their medications
Patient Educ. Couns.
(1992) - et al.
Emergency department patient knowledge of medications
J. Emerg. Med.
(2000) Adding medications in the emergency department: effect on knowledge of medications in older adults
J. Emerg. Nurs.
(1999)- et al.
Medicated hypertensive patients’ views and experience of information and communication concerning antihypertensive drugs
Patient Educ. Couns.
(1997) - Lorig K. Patient education. 2nd edition, SAGA publication;...
- et al.
Effects of self-medication program on knowledge of drugs and compliance with treatment in elderly patients
Br Med J
(1995) The effects of medication education on adherence to medication regimens in an elderly population
JAN
(1995)- et al.
A self-medication scheme for elderly patients improves compliance with their medication regimens
Int J Pharm Prac
(1992) - et al.
Who provides patients with drug information?
Br Med J
(1987) - et al.
Is asthma self-management cost-effective?
Patient Educ. Counsel
(1997)
Live and learn: patient education delays the need to initiate renal replacement therapy in end-stage renal disease
J. Nervous Mental Dis.
Cost-effectiveness of a structured treatment and teaching program on asthma
Eur. Resp. J.
Cited by (84)
Evaluation of Discharge Training Given to Patients Undergoing Revascularization
2023, Journal of Perianesthesia NursingInpatients’ information needs about medication: A narrative systematic literature review
2023, Patient Education and CounselingAlways InforMED: Nurse champion-led intervention to improve medication communication among nurses and patients
2020, Applied Nursing ResearchCitation Excerpt :Providing effective communication regarding medications is an important responsibility of nurses that is related to both health outcomes and patient satisfaction. Studies have shown that while patients were more likely to understand the purpose of their new medications, only 14 to 25% of patients were able recall any information about side effects (Kerzman, Baron-Epel, & Toren, 2005; Makaryus & Friedman, 2005; Maniaci, Heckman, & Dawson, 2008). If patients are not satisfied with the information provided to them regarding their medication, they may be more likely to become noncompliant with their medication regimen; this could lead to increased risk of adverse events and/or side effects (Borgsteede, Karapinar-Çarkit, Hoffmann, Zoer, & van Bemt, 2011).
Nursing students use of teach-back to improve patients' knowledge and satisfaction: A quality improvement project
2020, Journal of Professional NursingCitation Excerpt :A consideration for a future PDSA would be to implement a campaign to ensure the involvement of family or caregivers during medication education during the patient's hospitalization. As previous research noted, involving the patient's family members or caregivers in the patient's education about medications had a positive effect on the patient's medication compliance after discharge and readmission rate (Cargill, 1992; Foust, Naylor, Bixby, & Ratcliffe, 2012; Kerzman, Baron-Epel, & Toren, 2004). In the current quality improvement project, there were no patient complaints.