Implementation of patient-centered prescription labeling in a safety-net ambulatory care network.

Purpose. An initiative to implement patient-centered medication labeling at 4 pharmacies within a publicly funded safety-net healthcare system is described. Summary. Medication nonadherence negatively affects patient outcomes and safety. Nonadherence has been attributed to poor understanding of inst...

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Publicado en:American Journal of Health-System Pharmacy Vol. 75; no. 16; pp. 1227 - 1239
Autores principales: Khoong, Elaine C., Cherian, Roy, Smith, David E., Schillinger, Dean, Wolf, Michael S., Sarkar, Urmimala
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA 8/15/2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 8/15/2018
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      pub: Oxford University Press / USA
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        atl: Implementation of patient-centered prescription labeling in a safety-net ambulatory care network.
      aug:
        au:
          Khoong, Elaine C.
          Cherian, Roy
          Smith, David E.
          Schillinger, Dean
          Wolf, Michael S.
          Sarkar, Urmimala
        affil: UCSF Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA
      sug:
        subj:
          Safety-Net Providers
          Drug Labeling
          Medication Compliance
          Pharmacy Service
          Human
          Audit
          Health Literacy
          Program Implementation
      ab: Purpose. An initiative to implement patient-centered medication labeling at 4 pharmacies within a publicly funded safety-net healthcare system is described. Summary. Medication nonadherence negatively affects patient outcomes and safety. Nonadherence has been attributed to poor understanding of instructions on medication labels. Research has demonstrated that patient-centered labeling (PCL) can improve adherence and produce safer medication-taking practices. As part of a mixed-methods study by a safety-net health system, audits of nearly 9,000 prescription labels generated at 4 pharmacy sites, as well as interviews with 6 stakeholder informants, were conducted to determine PCL adoption rates and factors contributing to success. Descriptive statistics were used to analyze audit data; constructs of the Consolidated Framework for Implementation Research were used to analyze interview data. Among the 4 sites, 3 pharmacies successfully converted more than 85% of audited prescriptions to a PCL format; 1 pharmacy converted less than 25% of prescriptions. Barriers to implementation included pharmacists' reluctance to modify prescriber instructions and inadequate real-time data on conversion rates. Interviewees perceived that leadership and policy directives promoted PCL conversion efforts. Successful pharmacies used adaptable software, had closer communication networks with prescribers, and/or used automation to facilitate PCL conversion. Conclusion. Three pharmacies successfully converted more than 85% of labels for audited prescriptions to a PCL format; 1 pharmacy converted less than 25% of prescriptions. Barriers to implementation included pharmacists' reluctance to modify prescriber instructions, inadequate real-time data on conversation rates, and lack of customizable software to automate changes.
      pubtype: Academic Journal
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    language: English
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