Study unlocks safer, more effective approach to medication management

A recent study has shown that patients who participate in a program that teaches how to effectively take their medicine can better manage complex medication regimes when they return home.

A recent study of 90 patients that took part in the self-medication program at the QEII’s Nova Scotia Rehabilitation and Arthritis Centre found that a patient’s ability to manage medication increased to 92.3 per cent after taking part in the program, up from 86.3 per cent.

“The self-medication program is unique in Nova Scotia,” says Heather Neville, a pharmacist and pharmacy research coordinator with Nova Scotia Health.

Patients also had fewer errors in the dosage of medication, and their ability to take their medication after being discharged was very high. Patients were assessed while in hospital and were followed up with at four weeks and six months after discharge.

“The results that we got from the study are that the self-medication program is working really well,” says Heather. “We want to now improve the efficiency of the program.”

Medication self-management is an essential skill that patients should learn before being discharged. Without it, they are at higher risk of returning to the hospital and experiencing more severe symptoms of disease, says Heather.

Heather and her team received a Rehabilitation Program Endowment Fund grant from the QEII Foundation for their project, “Self-Medication Program at the Nova Scotia Rehabilitation and Arthritis Centre: Patient Outcome Study.” They also received support from the Nova Scotia Health Authority Research Fund.

The primary goal of the study was to determine if enrollment in the centre’s long-standing, self-medication program affects a patient’s capacity to manage medications better after returning home.

Robert Patey, a serving member of the Royal Canadian Air Force and retired HRM volunteer fire chief, was taking several pills a day for his diabetes, kidney disease, and PTSD last year when he fell at home, hit his head, and suffered a central spinal cord injury.

During his eight months at the QEII’s Nova Scotia Rehabilitation and Arthritis Centre following his accident, Robert took part in the self-medication program and learned how to effectively manage the 26 pills he is now required to take daily.

“It’s important to know what you are taking and why — the why is so important,” says Robert. “It is all about information and the self-medication program teaches the patients about their meds.”

Education is a key component of the self-medication program. In the program, patients receive information on each medication they take, as well as all the possible side effects. Patients participate in the self-medication program to improve their medication knowledge, increase their independence, and prepare to return home.

The program is managed by an interdisciplinary team that includes nurses, occupational therapists, pharmacy staff and physiatrists. After patients are assessed on their memory, understanding and functional ability to self-administer their medications, they are asked to
participate in the self-medication program. In the study, patients were in the program for approximately six weeks.

Initially, nurses have control of all medications. In the program’s second phase, patients access their medications, take them independently and have a nurse check daily to ensure that all medications are taken and accounted for. They also quiz patients on their medications, ensuring they know what each medication is that they’re taking. In the third phase, patients self-administer medications with a nurse checking in once a week.

 “The more the patient knows about what they are taking and why, the better,” says Eve Tait, a clinical nurse educator at the Nova Scotia Rehabilitation and Arthritis Centre. “The patient is more in control of their health.”

The Rehabilitation Program Endowment Fund was created in 1996 by the QEII Foundation to provide long-term funding for the Rehabilitation Program at the QEII Health Sciences Centre. The fund provides annual grants that are used for things such as purchasing specialized equipment, developing new programs and supporting research.