gms | German Medical Science

Background: A standardized medication plan (MP) for patients has been developed and recently enacted into German law (§ 31a SGB V) depicting all medicines taken. It has never been studied if patients understand a MP and can transfer the given information into practice.

We evaluated patients’ comprehensibility of the medication plan and analyzed potential associated variables.

Materials and Methods: We conducted face-to-face interviews to evaluate the comprehensibility of the standardized MP. The MP template v2.0 was first tested in N=40 patients, and the “Evaluation Tool to test the handling of the Medication Plan” (ET-MP) was developed, rating patients’ understanding from 0-100%. The cut-off, distinguishing if patients understand the MP, was set at 90%. The ET-MP was then applied to an amended MP questioning N=40 general internal medicine (GIM) and N=50 patients with chronic heart failure (CHF).

Results: The mean (±SD) age of the main study cohort (N=90) was 69±13 years, 47% female. Patients took 8±3 drugs chronically. CHF patients had a lower level of education compared to GIM (p=0.004). The overall ET-MP score was 82±21% (GIM 86±19%, CHF 78±23%; p=0.16). 43% achieved a score >90%. A moderate correlation was found between the score and the level of education (r=0.45) and age (r= -0.46), respectively (both p<0.001). Cognitively impaired CHF patients (p=0.03) and patients with advanced CHF (NYHA III/IV; p=0.006) achieved a lower ET-MP score. In the CHF cohort, signs of depression or a lower level of self-care behavior were not associated with a lower ET-MP score.

Conclusion: The ET-MP is suitable to explore patients’ understanding of a MP. Less than 50% of the patients reached a score above 90%. Higher age and lower level of education but not the diagnosis of CHF seem to correlate with impaired understanding of the standardized MP. In addition to a MP, a significant number of patients are in need of further and continuous care to improve medication safety.