TY - JOUR
T1 - Family caregivers’ facilitation of daily adult prescription medication use
AU - Roter, Debra L.
AU - Narayanan, Siva
AU - Smith, Katherine
AU - Bullman, Ray
AU - Rausch, Paula
AU - Wolff, Jennifer L.
AU - Alexander, G. Caleb
N1 - Funding Information:
An earlier version of the manuscript was presented at the International Conference for Communication in Healthcare (ICCH), in Heidelberg, Germany in 2016. This work was supported by the U.S. Food and Drug Administration, Center for Drug Evaluation and Research under grant number 5U18FD004653-01. Project web site: www.Talkbeforeyoutake.org Disclaimer: The U.S. Food and Drug Administration, Center for Drug Evaluation and Research funded this project under a grant to the National Council on Patient Information, award 5U18FD004653-01. The contents of this presentation are solely the responsibility of the author(s) and do not necessarily represent the official views of FDA, CDER, or the U.S. Department of Health and Human Services. Disclosures: Dr. Alexander is Chair of the FDA’s Peripheral and Central Nervous System Advisory Committee, serves as a paid consultant to IMS Health, serves on an IMS Health scientific advisory board and serves as a member of OptumRx’s Pharmacy & Therapeutics Committee. This arrangement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. Siva Narayanan serves as a paid consultant for Abbott, AbbVie, Celgene, Incyte, Johnson & Johnson, Novartis, Pfizer, Teva, and Vertex Pharmaceuticals. Appendix A See . Table A1
Publisher Copyright:
© 2017
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/5
Y1 - 2018/5
N2 - Objective: To describe ways family members assist adult patients with prescription medications at home, during medical visits and at the pharmacy. Methods: Online survey of 400 adults (caregivers) who help another adult (care recipient) with prescription medication use. Regression modeled the contribution of caregiver communication during recipients’ medical visits, evaluation of physicians’ medication communication and discussions with the dispensing pharmacist on caregivers’ assistance with home medication management. Results: Female (68%) family members (94%) assisted care recipients with multimorbidity (mean 2.9 conditions) and polypharmacy (mean 3.2 prescriptions). On average, caregivers performed 3 visit communication behaviors (e.g., notetaking) and implemented 2.6 home medication management strategies (e.g., filling/monitoring pill boxes). Communication-related variables explained 17% of home medication management assistance; including caregivers’ visit communication (std. beta 0.31), physicians’ medication communication (std. beta 0.15) and pharmacist discussions (std. beta 0.10). The final model included recipients’ multimorbidity and caregiver education (std. betas 0.21 and 0.13) explaining 22% of caregiver assistance with home medication management. Conclusion: Caregivers’ assistance with safe and effective home medication use crosses care contexts and is facilitated by clinician and pharmacist communication. Practice implications: Support for caregiver engagement in healthcare conversations can contribute to patient adherence and family-centered, high quality care.
AB - Objective: To describe ways family members assist adult patients with prescription medications at home, during medical visits and at the pharmacy. Methods: Online survey of 400 adults (caregivers) who help another adult (care recipient) with prescription medication use. Regression modeled the contribution of caregiver communication during recipients’ medical visits, evaluation of physicians’ medication communication and discussions with the dispensing pharmacist on caregivers’ assistance with home medication management. Results: Female (68%) family members (94%) assisted care recipients with multimorbidity (mean 2.9 conditions) and polypharmacy (mean 3.2 prescriptions). On average, caregivers performed 3 visit communication behaviors (e.g., notetaking) and implemented 2.6 home medication management strategies (e.g., filling/monitoring pill boxes). Communication-related variables explained 17% of home medication management assistance; including caregivers’ visit communication (std. beta 0.31), physicians’ medication communication (std. beta 0.15) and pharmacist discussions (std. beta 0.10). The final model included recipients’ multimorbidity and caregiver education (std. betas 0.21 and 0.13) explaining 22% of caregiver assistance with home medication management. Conclusion: Caregivers’ assistance with safe and effective home medication use crosses care contexts and is facilitated by clinician and pharmacist communication. Practice implications: Support for caregiver engagement in healthcare conversations can contribute to patient adherence and family-centered, high quality care.
KW - Medication adherence
KW - Medication communication
KW - Practical adherence support
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U2 - 10.1016/j.pec.2017.12.018
DO - 10.1016/j.pec.2017.12.018
M3 - Article
C2 - 29352620
AN - SCOPUS:85040525420
VL - 101
SP - 908
EP - 916
JO - Patient Education and Counseling
JF - Patient Education and Counseling
SN - 0738-3991
IS - 5
ER -