You know those little dosage cups that are on all the children’s over the counter medications…One study from 2010 found that only 30% of those using these cups with printed markings gave accurate dosages. Large errors (40% off ) were made by ¼ of the parents using the printed cup. In fact cups were associated with increased odds of making dosing errors compared to oral syringes. Limited health literacy was associated with making a dosing error. ***
These studies are just the tip of the iceberg. They describe part of the huge problem with medication errors that occur daily.
What can we, as consumers and caregivers, do to reduce errors? We can turn to others, part of the healthcare team who are often forgotten, but who are trained to help and who are available when we purchase medication–pharmacists.
Goldina Erowele is a clinical pharmacist and caregiver who has recently co-founded an online magazine called CareNovateMag.com.
“To a pharmacist, health literacy is the caregiver’s and patient’s understanding of instructions on their prescription drug bottle,” Dr. Erowele states. Health literacy is about “caregivers’ and patients’ ability to hear, read, process and understand basic services they need to make health decisions.”
Today, shorter face time with physicians increases the opportunity for misunderstandings. Dr. Erowele is concerned about the growing problem of medication compliance and medication errors. She feels that improving health literacy of caregivers can help. “Being a caregiver to a senior with high BP means the caregiver needs to have a understanding on what high BP symptoms are.” It’s important for caregivers to buy into the health literacy learning curve in order to serve their loved ones, Dr. Erowele believes, but she knows that “the learning curve can be huge.”
On a daily basis patients will nod their heads at what the doctor is saying, then, when the doctor leaves the room they will turn to their family, the nurse or whoever is there and say “What does that mean?”
“Healthcare providers can make it easier on patients and caregivers by using less jargon and more plain language,” Dr. Erowele states. She explains, “instead of healthcare providers saying to patient ‘you are getting an analgesic,’ they should say, you are getting a ‘pain killer’.” Dr. Erowele recommends this plain language website for help.
But plain language has to be paired with an understanding of what the patient knows. “Health literacy also needs to include interpretation, for example what does taking medication three times a day really mean? It’s different for everyone, depending on work schedule, sleep schedule, support, home environment,” says Dr. Erowele.
You have to start with the patient. For example, many people are visual learners. “I use pictures, educational videos or infographics to help [with understanding]. I draw pictures for patients…whatever it takes,” Dr. Erowele states.
“Self-efficacy or caregivers’ confidence and ability to assist with medications, is an important determinant of medication adherence,” Dr. Erowele believes. That’s why she has been a player in starting CareNovateMag.com. CareNovateMag.com is a new web magazine that is attempting to bring together resources that are spread over the web. “The reason we started CareNovateMag.com is so we can provide information, tools and resources that focus on caregivers,” Dr. Erowele says.
Through this initiative Dr. Erowele has been able to bring to light drug interactions that are easily avoided. She relates, “Blood thinners and leafy greens could be a bad combination. Grapefruit juice interaction are big news. It’s important to avoid grapefruit with some high blood pressure, high cholesterol medications.”
Caregivers are overwhelmed. Dr. Erowele hopes that CareNovateMag.com can be part of the solution.
*Dr. Erowele and her colleagues have developed a survey that she would like caregivers and patients to complete. Go to http://www.carenovatemag.com/1-min-poll-medication-info-and-resources-for-caregivers/
**Dr. Erowele recommends this website with videos on medication management for caregivers http://nextstepincare.org/Caregiver_Home/
***Yin, H., Mendelsohn, A., Wolf M., Parker R., Fierman A., van Schaick L., Bazan I., Kline M. & Dreyer B. (2010). Parents’ medication administration errors: role of dosing instruments and health literacy. Arch Pediatr Adolesc Med. Feb;164(2):181-6. doi: 10.1001/archpediatrics.2009.269.
Based on #hchlitss twitter chat. For transcript look here.