med ed : making sense of medication. a reflective exercise… in your practice, do you: work with...
TRANSCRIPT
Med Ed : Making sense of medication
A reflective exercise…In your practice, do you: Work with youth who take medications? Feel that youth have enough information
about their medications? Find information about medications for your
clients? Feel that this information is readily available
and accessible?
Today’s presentation Background and context Resource development Description Using Med Ed©
Training Evaluation Next steps
Background and context
Youth taking psychotropic medications often do not know enough about these medications
Youth-oriented materials are very hard to find
Most resources don’t work to promote dialogue between youth, caregivers, and health providers
The team
Developers2 pharmacists (Drs. Andrea Murphy and David Gardner)
1 psychiatrist (Dr. Stan Kutcher)
PartnersThe Provincial Centre of Excellence for Child and Youth Mental Health at CHEO(Drs. Ian Manion and Simon Davidson)
Other key people
Youth with mental illnesses Clinicians Graphic designer Plain language consultant Expert review panel
(Ontario) Legal consultation
Revisions Stakeholder
feedback
Revisions Stakeholder
feedback
Basic booklet template
Why are information sources about medications needed?
To enhance the client’s ability to make informed decisions about medication
To support collaborative treatment planning
To improve treatment-related outcomes
Considerations in developing information resources
What do clients want to know? What is the best way of getting this
information to clients? Who should be involved in the
conversation?
Source: Zwaenepoel L, et al. (2005), Pharm World 27:47-53
Ways to provide medication information
Verbal Written Video Internet Media
Concerns with the Internet
Consumers frequently default to the Internet to find health and medication information
Clients rarely share or discuss information that they have found on the Internet with their health providers
Information found on the Internet is often inaccurate or misleading
Source: Diaz JA, et al. J Gen Intern Med. 2002;17:180-185; Sciamanna CN, et al. Int J Med Inform. 2003;72:1-8; Hansen DL, et al. J Med Internet Res. 2003;5:e25.
Concerns with the media
1999 survey: 84% of Canadian doctors reported that they believed media reports influenced the kind of treatments their clients requested
1997 US National Health Council: 58% of people surveyed said they were prompted to modify some aspect of their behaviour by a health-related story reported in the media
Source: Gregg A, Kelly C, Sullivan M, Woolstencroft T. A report on the attitudes of Canadian physicians regarding media coverage of health issues. Toronto: The Strategic Counsel, Inc.; 1999; Americans talk about science and medical news: the National Health Council Report. New York: Roper Starch Worldwide; 1997.
Concerns with written materials
Documents are too long Information is “common knowledge” Print is too small Difficult to understand/language barriers Information is worrisome Information is confusing Information is not useful
Source: Nathan JP, et al. Ann Pharmacother 2007; 41:777-82.
Despite this, the literature says that… Clients still prefer to receive medication
information verbally or through printed materials
Health care providers tend to prefer face-to-face interactions and paper-based resources
Multiple approaches work best
Source: Raynor DK, et al. Health Technol Assess. 2007;11:iii, 1-160; Bennett NL, et al. BMC Med Inform Decis Mak. 2005;5:9; Bennett NL, et al., J Contin Educ Health Prof. 2006;26:120-127; Murphy AL, et al. BMC Nurs. 2006; 5:5.
The purpose of Med Ed©
• Information and knowledge exchange
• Collaborative decision-making • Client participation
Med Ed© is not intended to…
• Substitute or replace information and discussions that occur with a client’s health providers
• Serve as a stand alone resource to answer all of a client’s or caregiver’s questions about medications
Target users1. Youth aged 12 to 24 either currently
using or considering psychotropic medication as a part of treatment for a mental illness
2. Parents/caregivers and family members3. Health providers such as physicians,
pharmacists, nurses, psychologists, occupational therapists, and social workers
The resource
Developing the content
1. Order of information
2. Style (font, size, graphics)
3. “Medicaleze”
4. Illustrations
5. Written at a grade 6 level
6. Concise, bulleted format
7. Consistent design and information
The booklet
Content rich Three main sections:
• Frequently asked questions (FAQs)
• Tools and checklists• Glossary
The passport
Portable, concealable Full of tools A companion to the booklet Abbreviated sections
• FAQs• Checklists
Med Ed© Content
Contact information
General information and disclaimers
Legal rights regarding meds in Ontario
Q: What information should be provided to
me about my treatment?
Q: I consented to treatment, but now I’ve
changed my mind. What should I do?
FAQs Q: How long do I need to take this medication?
Q: Will taking this medication affect my relationship with my boyfriend/girlfriend?
Q: Everyone keeps talking about side
effects – what are they?
Med Ed© information boxes
Table of medicationsClasses of drugs
Anti-anxiety and sleep medications
Common group namesBenzodiazapines
AntihistaminesAntidepressants
Common examplesGeneric nameTrade name
Side effects
Med Ed© Tools
Checklists
Designed to support communication between clients and care providers
Lists questions to ask prescriber and pharmacist
Includes space to make notes
Checklist Doc
What is this medication for?
Should I avoid any foods or alcohol?
What are my other treatment options?
What should I do if I have an emergency?
Trackers
Also includes…
Medication list Appointments Notes page Glossary
Med Ed© Passport
Includes: FAQs Tools Trackers Medication list Appointments
Med Ed© training Train-the-trainer model 38 trained champions from across the
province in a range of roles (mental health counselling, residential care, psychiatry, psychology, nursing, pharmacy)
Champions are currently providing training within their organizations
Ongoing support is provided to champions via web portal and regular teleconferences
Med Ed© evaluation Focus
• Effectiveness of training, utility of tool for end-users
Sources• Champions, trained service providers, end-users
(youth and caregivers)
Methods • Questionnaires, telephone interviews
Preliminary findings related to trainingN Mean (/6)
The Med-Ed© tool is easy to learn 74 5.55
It is easy to use 74 5.45
It is useful for decision-making for children and youth on psychotropic medications
72 5.33
I can find the time to disseminate the Med-Ed© tools
73 4.90
It is too much trouble to apply 74 2.26
It is consistent with other initiatives in our organization
71 4.70
Preliminary findings related to the toolA good resource to help clients take ownership of their treatment…
Just a great way to engage kids in their health care…
This is a great idea and instrument with many possibilities…
…very informative for my every day administering of meds…(helps me to) recognize my need to do more reviews on clients' meds…
Evaluation next steps• Continue to analyze data from new round
of champions and the service providers they train
• Conduct and analyze semi-structured interviews with service providers, parents/caregivers, and youth
Med Ed© in your practice setting
Just because Med Ed© is available doesn’t mean it will be used
A number of variables influence whether or not health care innovations are adopted
Small group exercise What factors may influence the
uptake of Med Ed© in your practice setting?
What are the barriers? What are the facilitators? What strategies can be used to
overcome barriers and capitalize on facilitators?
Next steps…
Continued evaluation Ongoing supports for trained
champions Planning for future dissemination
Purnima Sundar, PhDResearch and Knowledge Exchange Consultant
613.737.7600 ext. [email protected]
www.onthepoint.ca
For more information: