Health Literacy and Medication Knowledge: Will a Graphic Medication Form Improve Medication Recall After Discharge?

Purpose:
This project addresses health literacy and medication adherence using an internet-based graphic medication form. The goal was to increase the perception of hospitalized cardiac patients that medication instructions were easy to follow and to improve patient recall of medications after discharge.

Significance:
Low health literacy has a negative impact on outcomes, including medication adherence. This is a huge barrier for patients with chronic disease. The ability to understand and follow medication instructions after discharge is crucial for cardiac patients who may take five or more medications daily.

Strategy and Implementation:
Patients received medication education using either the standard process of a text-only list of medications reviewed by a discharge nurse or experienced this same process with the addition of a graphic medication form. This form was created for each patient on MedActionPlan.com by the project leaders and a pharmacist. It included pictures of some drugs, the name, the dose, when to take, the medications, and the purpose of each. After discharge, nurses call patients at home with some routine questions. For this project, patients were also asked if instructions were easy to understand, and to list their medications and their purpose. The same questions were asked of one group before the form was introduced and then another group after the form was given out. In the second group, patients were called by the project leaders because nurses found that having patients list their medications caused a considerable increase in the amount of time it took to complete the post-discharge call.

Evaluation:
Patients in both groups reported their medication instructions were easy to understand. However, a statistically significant number of patients who received the graphic medication form were able to accurately recall their medications compared to the group who received the text-only medication list.

Implications for Practice:
While the project did demonstrate improved patient recall of medications after discharge with the graphic form, it was found to be time consuming to create and evaluate. A graphic form that populates from the existing electronic health record may be more viable from a cost-saving perspective.