Impact of patient-centered prescription medication labels on adherence in community pharmacy.

BACKGROUND: Prescription medication labels are often constructed in a manner which hinders safe and appropriate use of medicines. The United States Pharmacopeia released voluntary standards to revise medication labels in an effort to support patients' understanding and improve medication use. OBJECTIVE: To examine the impact of label changes on medication adherence before and after pharmacy implementation of the United States Pharmacopeia patient-centered prescription medication label standards. METHODS: This study used a retrospective pre-post cohort design. Prescription fill claims data were obtained from a community health plan serving Medicaid patients for 1 independent community pharmacy organization across 8 retail pharmacy sites. We calculated medication possession ratios (MPR) and proportion of days covered (PDC) for medications used for contraception, asthma, hypertension, and depression from 15 months before to 13 months after implementation of the label changes. RESULTS: Findings showed significant increases in mean MPR for asthma controller (increased by 0.111 [t = 0.290, P<0.0001]), antihypertensives (increased by 0.062 [t = 0.146, P < 0.0002]), and contraceptives medications (increased 0.133 [t = 0.209, P < 0.0001]) from preintervention to postintervention periods. Results also revealed increases in mean PDC for asthma controllers (increased by 0.193 [t = 0.267, P < 0.0001]), antihypertensives (increased by 0.067 [t = 0.175, P = 0.049]), and contraceptives (increased by 0.111 [t = 0.208, P < 0.0119]) from preintervention to postintervention periods. CONCLUSION: We report an association between a change to more patient-centered prescription medication labels and increased medication adherence based on MPR and PDC among Medicaid recipients.

How Health Literacy Develops the 'Four Aims' of Better Health Care.

The chapter's audience and purpose are twofold. First, the chapter introduces the 'Quadruple Aim' to policy makers and provides a general overview of health literacy strategies and tools to meet the Quadruple Aim to enhance care delivery while reducing costs. Second, the chapter identifies gaps in health literacy related research and encourages a research agenda to further the evidence base of health literacy to reduce cost, enhance quality, increase access, improve satisfaction, and achieve health equity.

Health Literacy Initiatives and Lessons Learned with NGOs: Wisconsin Health Literacy.

This report discusses necessary steps to help ensure successful community-based health literacy interventions using adult learning principles. Two workshop topics are covered: one on the flu and the other on the safe and effective use of opioids. Successful implementation includes conducting a needs assessment, developing project content, identifying target audiences, building strong community partners, implementing the workshops, and evaluating outcomes. The report also features the importance of patient-centered prescription medication labels to improve patient understanding, safety, and adherence. Results from a case study suggest redesigned labels that are patient-centered are easier to understand and improve adherence.

Prioritized Health Literacy and Clear Communication Practices For Health Care Professionals.

BACKGROUND: Health care professionals need more and better training about health literacy and clear communication to provide optimal care to populations with low health literacy. A large number of health literacy and clear communication practices have been identified in the literature, but health professions educators, administrators, and policymakers have lacked guidance regarding which practices should be prioritized among members of the health care workforce. OBJECTIVE: This study sought to prioritize recommended health literacy and clear communication practices for health care professionals. METHODS: A Q-sort consensus method was used among 25 health literacy experts to rank a previously identified list of 32 health literacy and clear communication practices for health care professionals. Mean ratings for each of the 32 practices were compared using t-tests. KEY RESULTS: Mean ratings for the 32 practices fell along a spectrum from higher to lower importance. The eight top-rated practices formed a cluster, and seven of these items demonstrated clear consensus, whereas one item may have been influenced by one or more outlier rankings. CONCLUSIONS: Although a large number of health literacy and clear communication practices have been recommended in the literature for health care professionals, this is the first known study to rank such practices in terms of importance. The top-rated items can be considered a core set of practices that all health care professionals should learn and routinely use in clinical settings. These consensus opinion results will help health professions educators, administrators, and policymakers to direct potentially limited resources toward improving training in patient-centered communication, and when designing curricula, practice standards, care delivery models, and policies for health care professionals and systems to improve patient outcomes. Future studies should empirically confirm the relative value of the ranked items in terms of patient-centered outcomes. [Health Literacy Research and Practice. 2017;1(3):e90-e99.]. PLAIN LANGUAGE SUMMARY: This is the first study to rank the most important things that health care workers can do to communicate more clearly with patients. A group of 25 experts ranked 32 items in order of importance. The list can be used to improve training for health care workers.

Health literacy practices and educational competencies for health professionals: a consensus study.

Health care professionals often lack adequate knowledge about health literacy and the skills needed to address low health literacy among patients and their caregivers. Many promising practices for mitigating the effects of low health literacy are not used consistently. Improving health literacy training for health care professionals has received increasing emphasis in recent years. The development and evaluation of curricula for health professionals has been limited by the lack of agreed-upon educational competencies in this area. This study aimed to identify a set of health literacy educational competencies and target behaviors, or practices, relevant to the training of all health care professionals. The authors conducted a thorough literature review to identify a comprehensive list of potential health literacy competencies and practices, which they categorized into 1 or more educational domains (i.e., knowledge, skills, attitudes) or a practice domain. The authors stated each item in operationalized language following Bloom's Taxonomy. The authors then used a modified Delphi method to identify consensus among a group of 23 health professions education experts representing 11 fields in the health professions. Participants rated their level of agreement as to whether a competency or practice was both appropriate and important for all health professions students. A predetermined threshold of 70% agreement was used to define consensus. After 4 rounds of ratings and modifications, consensus agreement was reached on 62 out of 64 potential educational competencies (24 knowledge items, 27 skill items, and 11 attitude items), and 32 out of 33 potential practices. This study is the first known attempt to develop consensus on a list of health literacy practices and to translate recommended health literacy practices into an agreed-upon set of measurable educational competencies for health professionals. Further work is needed to prioritize the competencies and practices in terms of relative importance.