title: Patients' handling of a standardized medication plan: a pilot study and method development.
abstract: OBJECTIVE
  The Action Plan for Medication Safety by the German Federal Ministry of Health introduced a standardized medication plan (MP), a printable document for the patient. The practical handling needs to be tested before the nationwide implementation in Germany. Therefore, the aims of our study were 1) to develop an instrument to evaluate the usage of the standardized MP, 2) to assess if patients can locate, and 3) understand important information. Moreover, we explored patients' opinion and suggestions regarding the standardized MP template.
  
  
  METHODS
  We conducted a cross-sectional study to evaluate the practical handling of the standardized MP. We interviewed 40 adult patients in seven community pharmacies in Germany, who took at least five medicines regularly and gave their written informed consent. The interview consisted of questions regarding finding and understanding information provided on a mock-up MP, patients' opinion and the execution of the information on the MP by filling pill boxes. We eventually developed a new evaluation method to quantify the practical handling of the MP by rating the pill boxes filled by the patients.
  
  
  RESULTS
  Overall, the participants rated the MP positively. Thirty-nine (98%) participants found important information on a mock-up standardized MP. Patients were questioned to identify if they understood information on medical intake as it relates to meals. In particular, they were questioned about medicine intake "1 hour before a meal", which 98% (n=39) interpreted correctly, and "during a meal", which 100% (n=40) interpreted correctly. The less precise advice of "before a meal" was interpreted correctly by 73% (n=29), and only 15% (n=6) correctly interpreted the term "after the meal". The evaluation of the filled pill boxes resulted in the "Evaluation Tool to test the handling of the Medication Plan" (ET-MP) - a weighted scoring system.
  
  
  CONCLUSIONS
  The standardized MP is clearly arranged, and patients are able to find important information. The findings of this study resulted in minor but important revisions of the standardized MP template. The developed evaluation tool ET-MP may serve as an objective instrument to assess patients' ability to transfer written information on the MP into practical handling of medicines.
authors.affiliation: Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany; Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany.
authors.forename: Lea
authors.initials: L
authors.lastname: Botermann
authors.affiliation: Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Krueger
authors.affiliation: Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Eickhoff
authors.affiliation: Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Kloft
authors.affiliation: Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany; Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany; Department of Pharmacology, Goethe-University Frankfurt, Frankfurt am Main, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schulz
keywords: Action Plan for Medication Safety; ET-MP; Germany; medication plan; medication schedule; patient safety; pharmacotherapy