Development and Evaluation of a Medication Counseling Workshop for Physicians: Can We Improve on 'take Two Pills and Call Me in the Morning'?

Overview

Journal Med Educ Online

Specialty Medical Education

Date 2011 Sep 15

PMID 21915162

Citations 10

Authors

Sunil Kripalani

Chandra Y Osborn

Viola Vaccarino

Terry A Jacobson

Affiliations

Soon will be listed here.

Abstract

Background: Physicians often do not provide adequate medication counseling.

Purpose: To develop and evaluate an educational program to improve physicians' assessment of adherence and their medication counseling skills, with attention to health literacy.

Methods: We compared internal medicine residents' confidence and counseling behaviors, measured by self-report at baseline and one month after participation in a two-hour interactive workshop.

Results: Fifty-four residents participated; 35 (65%) completed the follow-up survey. One month after training, residents reported improved confidence in assessing and counseling patients (p<0.001), including those with low health literacy (p<0.001). Residents also reported more frequent use of desirable behaviors, such as assessing patients' medication understanding and adherence barriers (p<0.05 for each), addressing costs when prescribing (p<0.01), suggesting adherence aids (p<0.01), and confirming patient understanding with teach-back (p<0.05).

Conclusion: A medication counseling workshop significantly improved residents' self-reported confidence and behaviors regarding medication counseling one month later.

Citing Articles

Students' Perceived Counseling Behavior and Feedback on a University-led Patient Medication Counseling Program Implemented in a Tertiary Government Hospital.

Ngo F, Cadag C, Ordonez J Acta Med Philipp. 2025; 58(21):30-39.

PMID: 39758296 PMC: 11694035. DOI: 10.47895/amp.vi0.8335.

Development, implementation, and evaluation of Teach Back curriculum for community health workers.

Holcomb J, Ferguson G, Thornton L, Highfield L Front Med (Lausanne). 2022; 9:918686.

PMID: 36405583 PMC: 9669070. DOI: 10.3389/fmed.2022.918686.

A population-based study of self-reported adverse drug events among Lebanese outpatients.

Ramia E, Zeenny R, Hallit S, Salameh P Sci Rep. 2021; 11(1):7921.

PMID: 33846425 PMC: 8041830. DOI: 10.1038/s41598-021-87036-x.

You Can Teach Every Patient: A Health Literacy and Clear Communication Curriculum for Pediatric Clerkship Students.

Spengler E, Schechter M, Pina P, Rhim H MedEdPORTAL. 2021; 17:11086.

PMID: 33501376 PMC: 7821440. DOI: 10.15766/mep_2374-8265.11086.

Effect of a health literacy intervention trial on knowledge about cardiovascular disease medications among Indigenous peoples in Australia, Canada and New Zealand.

Crengle S, Luke J, Lambert M, Smylie J, Reid S, Harre-Hindmarsh J BMJ Open. 2018; 8(1):e018569.

PMID: 29371275 PMC: 5786120. DOI: 10.1136/bmjopen-2017-018569.

References

Reichert S, Simon T, Halm E . Physicians' attitudes about prescribing and knowledge of the costs of common medications. Arch Intern Med. 2000; 160(18):2799-803. DOI: 10.1001/archinte.160.18.2799. View

Schnipper J, Roumie C, Cawthon C, Businger A, Dalal A, Mugalla I . Rationale and design of the Pharmacist Intervention for Low Literacy in Cardiovascular Disease (PILL-CVD) study. Circ Cardiovasc Qual Outcomes. 2010; 3(2):212-9. PMC: 3021350. DOI: 10.1161/CIRCOUTCOMES.109.921833. View

Gazmararian J, Jacobson K, Pan Y, Schmotzer B, Kripalani S . Effect of a pharmacy-based health literacy intervention and patient characteristics on medication refill adherence in an urban health system. Ann Pharmacother. 2009; 44(1):80-7. DOI: 10.1345/aph.1M328. View

Masoudi F, Baillie C, Wang Y, Bradford W, Steiner J, Havranek E . The complexity and cost of drug regimens of older patients hospitalized with heart failure in the United States, 1998-2001. Arch Intern Med. 2005; 165(18):2069-76. DOI: 10.1001/archinte.165.18.2069. View

Kripalani S, Weiss B . Teaching about health literacy and clear communication. J Gen Intern Med. 2006; 21(8):888-90. PMC: 1831575. DOI: 10.1111/j.1525-1497.2006.00543.x. View

Morris L, Tabak E, Gondek K . Counseling patients about prescribed medication: 12-year trends. Med Care. 1997; 35(10):996-1007. DOI: 10.1097/00005650-199710000-00002. View

Russell M, INSULL Jr W, Probstfield J . Examination of medical professions for counseling on medication adherence. Am J Med. 1985; 78(2):277-82. DOI: 10.1016/0002-9343(85)90438-3. View

Tarn D, Paterniti D, Heritage J, Hays R, Kravitz R, Wenger N . Physician communication about the cost and acquisition of newly prescribed medications. Am J Manag Care. 2006; 12(11):657-64. View

Kripalani S, Henderson L, Chiu E, Robertson R, Kolm P, Jacobson T . Predictors of medication self-management skill in a low-literacy population. J Gen Intern Med. 2006; 21(8):852-6. PMC: 1831567. DOI: 10.1111/j.1525-1497.2006.00536.x. View

10.

Seligman H, Wang F, Palacios J, Wilson C, Daher C, Piette J . Physician notification of their diabetes patients' limited health literacy. A randomized, controlled trial. J Gen Intern Med. 2005; 20(11):1001-7. PMC: 1490250. DOI: 10.1111/j.1525-1497.2005.00189.x. View

11.

Kripalani S, Yao X, Haynes R . Interventions to enhance medication adherence in chronic medical conditions: a systematic review. Arch Intern Med. 2007; 167(6):540-50. DOI: 10.1001/archinte.167.6.540. View

12.

Schillinger D, Bindman A, Wang F, Stewart A, Piette J . Functional health literacy and the quality of physician-patient communication among diabetes patients. Patient Educ Couns. 2004; 52(3):315-23. DOI: 10.1016/S0738-3991(03)00107-1. View

13.

McDermott M, Schmitt B, Wallner E . Impact of medication nonadherence on coronary heart disease outcomes. A critical review. Arch Intern Med. 1997; 157(17):1921-9. View

14.

Williams M, Parker R, Baker D, Parikh N, Pitkin K, Coates W . Inadequate functional health literacy among patients at two public hospitals. JAMA. 1995; 274(21):1677-82. View

15.

Jenkins L, Britten N, Stevenson F, Barber N, Bradley C . Developing and using quantitative instruments for measuring doctor-patient communication about drugs. Patient Educ Couns. 2003; 50(3):273-8. DOI: 10.1016/s0738-3991(03)00049-1. View

16.

Kalichman S, Ramachandran B, Catz S . Adherence to combination antiretroviral therapies in HIV patients of low health literacy. J Gen Intern Med. 1999; 14(5):267-73. PMC: 1496573. DOI: 10.1046/j.1525-1497.1999.00334.x. View

17.

Rahimi A, Spertus J, Reid K, Bernheim S, Krumholz H . Financial barriers to health care and outcomes after acute myocardial infarction. JAMA. 2007; 297(10):1063-72. DOI: 10.1001/jama.297.10.1063. View

18.

Baker D, Williams M, Parker R, Gazmararian J, Nurss J . Development of a brief test to measure functional health literacy. Patient Educ Couns. 2003; 38(1):33-42. DOI: 10.1016/s0738-3991(98)00116-5. View

19.

Kripalani S, Jacobson T, Mugalla I, Cawthon C, Niesner K, Vaccarino V . Health literacy and the quality of physician-patient communication during hospitalization. J Hosp Med. 2010; 5(5):269-75. PMC: 3468649. DOI: 10.1002/jhm.667. View

20.

Reif S, Smith S, Golin C . Medication adherence practices of HIV/AIDS case managers: a statewide survey in North Carolina. AIDS Patient Care STDS. 2003; 17(9):471-81. DOI: 10.1089/108729103322395500. View