By Lori Maricle, College of Pharmacy
SPOKANE, Wash. – An educational toolkit to help older patients better manage medications recently received funding and is expected to be in use later this year, according to researchers at Washington State University Spokane.
The materials will be based on a recently completed WSU study of the impact of managing multiple chronic medical conditions in older populations. The goal of the toolkit is to empower older persons to better communicate with their health care providers regarding their medication therapies, with the aim of improving quality of life and reducing interactions and adverse side effects.
“Persons who take multiple medications create an identity around medication use that affects lifestyle, well-being, physical and psychological health,” said Joshua Neumiller, a WSU pharmacist, clinical researcher and a primary investigator on the project. “Identifying barriers and facilitators to proper use of medications and better understanding the practitioner-provider exchange are key to optimizing appropriate medication use.
“Medication safety is something our whole team is passionate about and is something we hope to improve through this study’s findings and the development of these educational tools,” he said.
Doctor proximity crucial
The research team found that, for a large portion of study participants, their doctor is one of the most important people in their lives.
“Some study participants even said they wouldn’t consider relocating, even if it would mean being closer to family or friends, because they ‘couldn’t leave their doctor,’ ” Neumiller said.
Participants said one of the most common barriers to taking medications as prescribed was not being able to fill the prescription (reasons given for this included lack of transportation and finances). The second-largest barrier was simply forgetting to take the medication, said Neumiller.
Patients as part of research team
The study recruited participants who were at least age 65, were taking at least five medications and were getting a new medication from their healthcare provider. Subjects kept a daily electronic diary, recording their feelings, perceptions, struggles or successes, side effects and ideas regarding their daily medication regimens. The team also selected 15 participants for in-depth interviews.
“As a health care system, we often approach problems like this from the perspective of how we can improve the system,” Neumiller said. “But including patients’ perspectives is what has been missing. Working with patients as members of the research team provides more insight into this problem that we didn’t have before.”
Patient, provider feedback smooths communication
Researchers will next conduct focus groups with patients who share similar medical conditions. Nurses, physicians and pharmacists will provide feedback about best practices for communicating with these specific patient groups.
“This will be a two-pronged approach to try to break down some of these barriers between patients and providers,” said Neumiller.
The research team has established community partnerships in Spokane to facilitate dissemination of the toolkit once it is developed. It will be tailored for ease of access and use for older adults.
Funder focuses on importance of patient
The initial research was funded by a $230,000 grant from the Patient-Centered Outcomes Research Institute (PCORI). The research team just received an additional $49,960 from PCORI over the next four months to develop the educational resources that will be made available to health care providers and patients.
The interdisciplinary research team included faculty from the WSU colleges of Pharmacy, Nursing and Communication and health care providers from Providence Medical Research Center and Providence Health Care in Spokane. Neumiller, Roxanne Vandermause from the College of Nursing and Katherine Tuttle, nephrologist and executive director for research at Providence Health Care, presented the initial findings at the National Kidney Foundation annual meeting in the spring.
Neumiller is a Spokane native and WSU alumnus. Learn more about him at http://www.pharmacy.wsu.edu/facultystaff/bios/neumiller.j.html.