Medication literacy: A conceptual model.

BACKGROUND: Medication literacy reflects the specific literacy skills necessary to act on medication-related information. A comprehensive and clear conceptual model that reflects medication literacy is lacking. Conceptual models describe the components that represent a construct, allowing for its understanding and providing a rationale for its measurement. OBJECTIVES: To propose a conceptual model to support the development of an instrument to measure medication literacy. METHODS: This is a three-phase methodological study. A literature review was conducted to identify the components that should be part of the preliminary conceptual model. Subsequently, the importance of its components was judged on a Likert-5 scale. Then, the model was refined, and the dimensions and subdimensions of medication literacy were defined. RESULTS: Forty-five experts were included, with a mean age of 39.9 (SD = 10.5) years, most of them females (86.7%) and pharmacists (80%). All components of the preliminary conceptual model were considered important to extremely important by most experts. "Dosing information", "medication name", and "processing the information received about their medication and acting upon medication instructions" were the components considered most important. In the refinement phase, we identified that the construct has four dimensions - functional literacy, communicative literacy, critical literacy, and numeracy, which include the subdimensions to access, understand, evaluate, calculate, and communicate medication-related information. CONCLUSIONS: The conceptual model allowed identifying the components that represent medication literacy, which will support the development of an instrument for measuring the construct in Brazil.

Service blueprint of comprehensive medication management: A mapping for outpatient clinics.

BACKGROUND: Comprehensive medication management (CMM) is a clinical service based on the theoretical and methodological framework of pharmaceutical care. Service blueprint is one of the most widespread visual tools of service design. It enables description of the processes involved in service provision that ultimately define patient experience. Although studies have shown the clinical, humanistic and economic benefits of CMM, its provision still involves several challenges, which can be minimized with the proper mapping of this service. However, this initiative has not yet been described in the literature using this specific tool. OBJECTIVES: To develop, apply and improve a blueprint for CMM services delivered in the ambulatory setting. METHODS: This qualitative study was organized in two phases. In phase 1, two expert panels were carried out to jointly create a generic service blueprint-model for CMM on ambulatory care involving nine specialists with diverse experiences in the area. In phase 2, the generic model was applied and improved in a public rheumatology clinic. The outcome of phase 2 was defined as the final generic service blueprint-model for CMM in the ambulatory setting. RESULTS: The final generic blueprint-model created has 21 customer actions, of which 2 are considered critical (with great potential for failure and to compromise the patient's experience with the service): "seeking and accepting the service invitation" and "accepting the care plan co-created with the pharmacist". Fifteen backstage actions (without the patient's awareness) were identified, and the most critical occurred in the post-service, such as collection of indicators. The need for 7 support processes was also identified, and 3 of which were critical. Nineteen physical pieces of evidence for the user of CMM service were defined, with consultation room as the only physical piece of evidence considered critical. CONCLUSIONS: The developed service blueprint can improve the patient's experience with CMM and facilitate communication with decision makers and other stakeholders. The model is proposed as a reference that can be customized to different ambulatory care settings.