Transplant Education Program Improves
Patient Medication Knowledge and Adherence

Suzanne Reed, RN, BSN, CCTC, CPTC; Ashley Feist, Pharm.D.; Elise Berry. MA; Alex Aussi RN, MBA; Caroline Brown, DEd, CNS; Gordon Yung, M.D.

University of California, San Diego Medical Center

BACKGROUND

MedActionPlan My Daily Schedule

Figure 1. Example MedActionPlan

  • Studies have shown that medication errors in the transplant setting are common and often lead to significant adverse events including hospitalizations and failed allografts
  • Compliance with medication regimens can be especially challenging in this setting since patients must comply with complex regimens
  • UCSD Center for Transplantation recently implemented two practice changes to improve medication management and improve patient adherence
    1. MedActionPlan™ adopted as standard medication list
      • This is a printable medication list with pictures, exact timetables for taking medications, as well as the purpose for each medication
    2. Transplant pharmacists added to all outpatient clinics

OBJECTIVES/METHODS

Objectives:

  • Assess patient satisfaction and medication taking beliefs after implementation of tools to improve medication management in lung and heart transplant patients

Design:

  • Cross-sectional survey design, IRB approved
    • 2 part anonymous survey with no identifiers sent via mail with pre-addressed, stamped envelope
    • Part 1 addressed use of medication list and pharmacist involvement
    • Part 2 included selected questions from the Beliefs Related to Medications Survey (BERMA)
      • 20 of the 60 question survey were selected
      • The questionnaire provided participants a Likert scale of 1-5, 1 as "Strongly Disagree" and 5 as "Strongly Agree"

Inclusion criteria:

  • All patients status post lung, heart, or heart/lung transplant being followed at our center

Data Analysis:

  • Descriptive statistics used to calculate frequencies, means and SD’s

RESULTS

Survey Questions with more than 50% Survey Respondents who “Agree” and Average Score for Corresponding Questions

Survey Questions with less than 50% Survey Respondents who “Agree” and Average Score for Corresponding Questions

Survey Response Rate:

  • Heart Transplant= 26/57, 46%
  • Lung or Heart/Lung Transplant = 52/89, 89%

Medication List Use: 95% (73/77)

Medication List brought to doctors appointment: 91% (70/77)

Type of Medication List Used:

  • MedActionPlan= 64% (49/77)
  • Different Medication List = 32% (25/77)
  • No List Used = 3% (4/77)
  • Not answered = 1% (1/77)

Percent and Level of Agreement of MedActionPlan List Users

DISCUSSION/CONCLUSIONS

  • MedActionPlan users have a high level of compliance and MedActionPlan allows for better communication between patients and transplant health care providers.
  • Pharmacists have provided improved medication management in the transplant clinics.
  • Patient satisfaction has improved with medication management initiatives.
  • Patient comments from survey:
    • “Everywhere I go with the med list, they are impressed. I would be lost without it. It helps keep me organized.”
    • “It is updated at every appointment and I use it all the time, thank you!”
    • “I find the MedActionPlan very helpful. The ability to access it online makes discussing meds with my doctors much more accurate and easier.”
    • “Participation of pharmacist at clinic is extremely beneficial.”

DISCLOSURES

We have no financial relationships to disclose and no conflicts of interest.