Retooling the Pharmacist to Improve Health Literacy
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Transcript of Retooling the Pharmacist to Improve Health Literacy
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Retooling the Pharmacist to Improve Health Literacy
Jennifer O’Callaghan, PharmDPGY1 Community Pharmacy Resident
University of Wisconsin Hospital and Clinics
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Disclosure Statement
I have no conflict of interest to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation.
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Learning Objectives
Identify ways pharmacy staff and other healthcare providers can recognize patients with low health literacy.
Define the Wisconsin Pharmacy Quality Collaborative (WPQC) program.
Describe ways the Wisconsin Pharmacy Quality Collaborative (WPQC) is identifying patients with low health literacy and implementing services aimed at improving medication adherence.
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Health Literacy
Ability to understand: prescription drug bottles educational brochures doctor’s directions consent forms
Ability to calculate medication dosages
Ability to interpret test results
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Identification of Patient with Low Health Literacy
“Even very literate people may have trouble obtaining, understanding, and using health information: a surgeon may have trouble using an insurance form, a science teacher may not understand information about a test of brain function, and an accountant may not know when to get a mammogram.”
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Identification of Patient with Low Health Literacy
Ask for medications by color or shape
Unable to explain purpose or dosing of medication
Non-compliance with medications
Lack of follow through on labs
Incomplete registration forms
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Identification of Patient with Low Health Literacy
May need more time to make health care decisions
Patients may hide their lack of understanding or may not even realize they have trouble understanding
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Take 2 tablets twice daily
Low health literacy 71% believed they understood the directions 35% able to demonstrate properly
Marginal health literacy 84% believed they understood the directions 63% able to demonstrate properly
Adequate health literacy 89% believed they understood the directions 80% able to demonstrate properly
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Creating the Right Environment for Health Literacy
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Fostering Open and Welcoming Attitudes
Smile and acknowledge the patient Always introduce yourself Speak in a slow, relaxed pace in a
conversational tone Listen and be empathetic Encourage patients to ask questions Ask “Am I clear?”
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Fostering Open and Welcoming Attitudes
Use interpreter services if available Use signs with pictures to tell patients
where to go and what they need Provide a waiting area Decorate the pharmacy
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Maintaining Consistency
Use larger prints Use 12-point Times or 11-point Arial Include brand and generic names Include medication purpose Use the same generic if possible Post questions to ask pharmacist
What is this medication for? What are the side effects?
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Incorporating Basic Healthcare Information
Use multiple types of learning styles People typically only remember 50% of what
they hear
Create written materials at 8th grade or lower (Goal for 5th grade reading level is best) Average reading level: 8-9th grade Patient education materials in chain
pharmacies 2% of materials at 7-8th grade 69% of materials at 9-12th grade 29% of materials at 12th grade or higher
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Incorporating Basic Healthcare Information
Avoid difficult medical terminology
Screening Oral Mental Health Monitor
Dermatologist Diabetes Annually Cardiovascular
Immunization Diet Depression Referral
Contraception Hygeine Respiratory problems
Eligible
Hypertension Prevention Community Resources
Arthritis
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Incorporating Basic Healthcare Information
2012 United States Pharmacopeial (USP) Convention Standards Use explicit directions Avoid from necessity of numerical skills
Examples
“Take 2 tablets twice daily”
“Take 2 tablets in the morning and take 2 tablets
in the evening”
“Take 1 tablet every 4 to 6 hours”
“Take 1 tablet 4 to 6 times daily”
“Take 1 tablet at 8am”“Take 1 tablet at the same
time every morning”
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Incorporating Basic Healthcare Information
Use a Pill Chart
Morning Afternoon Evening Night
Name: Sarah Smith Date Created: 12/15/12Pharmacy phone number: 123-456-7890
Name Used For Instructions
Simvastatin20mg
Cholesterol
Take 1 pill at night
Furosemide20mg
Fluid Take 2 pills in the morning and 2 pills in the evening
Insulin70/30
High blood sugars
Inject 24 units before
breakfast and 12 units before
dinner
24 units 12 units
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Incorporating Basic Healthcare Information
Focus on how to incorporate medications and health changes into the patient’s current lifestyle
Create a medication list for patients to bring to all appointments
Give patients a plan for their goals or other healthy lifestyle changes
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Wisconsin Pharmacy Quality Collaborative (WPQC)
WPQC is an initiative of the Pharmacy Society of Wisconsin (PSW) that is designed to engage health plans and pharmacy providers in a collaborative effort to improve medication use in Wisconsin
WPQC has established a credentialing Process and uniform set of pharmacist-provided medication therapy management services for participating Wisconsin pharmacy providers.
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Show and Tell
Showing the patient what the medication looks like
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What your pharmacist did for you today
Updated your information Checked your records
Allergies Interactions Safe and effective medications for your age and conditions Ways to save you money
Reviewed with you Why you are taking your medication How to take your medication How you can monitor your own therapy When to contact your doctor
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Teach-back Method
Teach-back is a way to confirm that you have explained to the patient what they need to know in a manner that the patient understands
Ask the patient to explain to you what you taught them
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Common Questions to Use for Teach Back
“I want to be sure that I explained your medication correctly. Can you tell me how you are going to take this medicine?”
“We covered a lot today about your diabetes, and I want to make sure that I explained things clearly. So let’s review what we discussed. What are three strategies that will help you control your diabetes?”
“What are you going to do when you get home?”
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WPQC and Health Literacy
Offers customized patient services and private medication appointments to ensure patients best understand their medications
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Health Literacy Criteria
Requires the use of a trained medical translator
Is unable to demonstrate pill count(s) Is familiar with personal medications by
color only Is unable to read or is suspected to have
very low literacy Is suspected to have adherence problems
due to low literacy Takes medications obtained from another
country
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WPQC Interventions
Focused adherence intervention Use lifestyle cues
Set medications by kitchen if taken with food
Set medications by bedside table if taken at bedtime
Use pill boxes Use alarms Create a schedule
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WPQC Interventions
Comprehensive medication review and assessment Personalized medication appointment
Medications use, directions, and side effects teaching
Device technique review Adherence consult
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How to refer your patients for a medication appointment
Patients with Medicaid, Unity, UnitedHealth Care, and Network Health are eligible
Check out pswi.org for a list of all participating pharmacies
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Questions?
Jennifer O’Callaghan, PharmDPGY1 Community Pharmacy Resident
University of Wisconsin Hospital and Clinics