Background Central to the care of patients in Day Hospice is an understanding of their compliance with medication. The Hospice has a Medicines Management Policy in place, but had no structured approach to measuring patients’ levels of concordance, from their perspective.
Aim of the Evaluation The aim of the evaluation was to develop a method by which patient compliance could be assessed, explored and improved
Method The National Institute for Clinical Excellence (NICE) produced guidance and a patient questionnaire on Medicines Adherence in 2009. The questions explore the role of the healthcare professional in supporting patient’s decision making, and understanding of their medicines. An amended version of the NICE questionnaire was developed and used, for which sixteen patients were randomly selected. Verbal consent was obtained and anonymity assured.
Results It provided useful information about our effectiveness in supporting patients with their medicines adherence. We scored well in engaging patients in joint decision-making, however some other aspects such as exploration of the burdens and benefits of medication, and common side effects needed improvement.
Some questions could be misinterpreted, and there was no facility to expand on answers given. The length and style of the questionnaire was quite difficult to implement with people who were fatigued and unwell.
Conclusions This evaluation has been important to our understanding of our effectiveness in supporting medicines adherence. We intend to inform NICE of the amendments made prior to using the questionnaire within specialist palliative day services. We aim to further develop the questionnaire to evaluate patients’ experiences and concerns regarding their medication regimes, and to address the need for carer involvement (End of Life Care Strategy 2008), as they underpin concordance for many of our patients.
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