Evaluating patients' comprehensibility of a standardized medication plan.
OBJECTIVE
A standardized medication plan for patients has been developed and recently enacted into German law depicting all medicines taken. It can only increase medication safety if patients use and understand it. We evaluated patients' comprehensibility of the medication plan and analyzed potential variables influencing patients' understanding.


METHODS
The medication plan template v2.0 was first tested in N = 40 patients, and the "Evaluation Tool to test the handling of the Medication Plan" (ET-MP) was developed, rating patients' understanding from 0 to 100 %. The cut-off, distinguishing if patients understand the medication plan, was set at 90 %. The ET-MP was then applied to an amended medication plan questioning N = 40 general internal medicine (GIM) and N = 50 patients with chronic heart failure (CHF).


RESULTS
The mean (± standard deviation (SD)) age of the study cohort was 69 ± 13 years, 47 % female. Patients took 8 ± 3 drugs chronically. The CHF patients had a lower level of education compared to the GIM group (p = 0.004). The overall ET-MP score was 82 ± 21 % (GIM 86 ± 19 %, CHF 78 ± 23 %; p = 0.16). Forty-three percent achieved a score >90 %. A moderate correlation was found between the ET-MP score and the level of education (r = 0.45) and age (r = -0.46), respectively (both p < 0.001). Cognitively impaired CHF patients (p = 0.03) and patients with advanced CHF (p = 0.006) achieved a lower ET-MP score. In the CHF cohort, signs of depression or a lower level of self-care behaviour were not associated with a lower ET-MP score.


CONCLUSIONS
The ET-MP is suitable to explore patients' understanding of a medication plan. Less than 50 % of the patients reached a score above 90 %. Higher age and lower level of education but not the diagnosis of CHF seem to correlate with impaired understanding of the standardized medication plan. In addition to a medication plan, a significant number of patients are in need of further and continuous care to improve medication safety.
Department of Medicine, ABDA-Federal Union of German Associations of Pharmacists, Unter den Linden 19-23, 10117, Berlin, Germany.|Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany.
Lea
L
Botermann
Department of Internal Medicine III-Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg/Saar, Germany.
Katharina
K
Monzel
Department of Medicine, ABDA-Federal Union of German Associations of Pharmacists, Unter den Linden 19-23, 10117, Berlin, Germany.
Katrin
K
Krueger
Department of Medicine, ABDA-Federal Union of German Associations of Pharmacists, Unter den Linden 19-23, 10117, Berlin, Germany.
Christiane
C
Eickhoff
Department of Internal Medicine III-Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg/Saar, Germany.
Angelika
A
Wachter
Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany.
Charlotte
C
Kloft
Department of Internal Medicine III-Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg/Saar, Germany.
Ulrich
U
Laufs
Department of Medicine, ABDA-Federal Union of German Associations of Pharmacists, Unter den Linden 19-23, 10117, Berlin, Germany. m.schulz@abda.de.|Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany. m.schulz@abda.de.|Drug Commission of German Pharmacists (AMK), Berlin, Germany. m.schulz@abda.de.
Martin
http://orcid.org/0000-0001-6011-5377
M
Schulz
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany; D057220:Health Literacy; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D008297:Male; D054539:Medication Therapy Management; D008875:Middle Aged; D019338:Polypharmacy
Medication plan; Medication safety; Medication schedule; Patients’ understanding; Polymedication; Polypharmacy