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Development of a Tool to Identify Problems Related to Medication Adherence in Home Healthcare Patients

Mahan, Kathryn R. PharmD Candidate; Clark, Jeffrey A. PharmD, BCGP; Anderson, Kurt D. PharmD; Koller, Nolan J. PharmD; Gates, Brian J. PharmD, BCGP

doi: 10.1097/NHH.0000000000000539
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In the home healthcare setting, clinicians are required to evaluate patient's medication therapy, including adherence. To facilitate this conversation, a pilot question list to help uncover potential medication nonadherence was created after completing a review of the literature and ascertaining the common themes as to why patients were nonadherent to their medication therapies. Pharmacy personnel who provide onsite consultations in a home healthcare setting used the question list to identify medication-related problems that could contribute to nonadherence and to document potential solutions. Through pharmacist–patient interactions, which occurred after admission to the home healthcare agency, pharmacy personnel found on average 2.3 issues per patient, which could affect medication adherence. Side effects were the most common problem identified. After this tool was tested with 65 patient interviews, the questions were analyzed and condensed into a shorter list more specific to the identification of medication-related problems for use by home care clinicians.

Kathryn R. Mahan is a PharmD candidate, College of Pharmacy, Washington State University, Spokane, Washington.

Jeffrey A. Clark, PharmD, BCGP, is a Clinical Assistant Professor, College of Pharmacy, Washington State University, and Consultant Pharmacist, Providence Visiting Nurses Association, Spokane, Washington.

Kurt D. Anderson, PharmD, is a Clinical Pharmacy Specialist — Ambulatory Care, Peace Health, Longview, Washington.

Nolan J. Koller, PharmD, is a Pharmacy Fellow, Geriatrics Department of Pharmacotherapy, College of Pharmacy, Washington State University, and Consultant Pharmacist, Providence Visiting Nurses Association, Spokane, Washington.

Brian J. Gates, PharmD, BCGP, is a Clinical Professor, College of Pharmacy, Washington State University, Consultant Pharmacist, Providence Visiting Nurses Association, and Associate Dean for Professional Education, Washington State University, College of Pharmacy, Spokane, Washington.

The authors declare no conflicts of interest.

Address for correspondence: Jeffrey A. Clark, PharmD, BCGP, Washington State University, PO Box 1495, Spokane, WA 99210-1495 (jeffrey_clark@wsu.edu)..

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