Improving the medication literacy at the time of discharge from hospital (the LiMeTiD study)

Abstract

Unintended discrepancy in medications at the time of discharge from the hospital is associated with an increased incidence of adverse drug events, including readmission to hospital. Medication literacy is an essential part of health literacy and can reduce medication discrepancies. This prospective observational cohort study aimed to measure the medication literacy of patients at the time of discharge from the hospital when managed with usual care and after the introduction of a medication literacy improvement instrument. This study involved a baseline cohort receiving usual care and a post-intervention cohort aged 50–80 years with high health literacy. The 7 Things I Should Know About My Medications at the Time of Discharge from Hospital instrument, in short, The 7 Domains MedLit Instrument, was designed by the researchers in addition to three medication literacy measurement questionnaires. Medication literacy was measured at 30 h post-discharge. The impact on readmission to hospital was assessed at 30 days post-discharge. The 7 Domains MedLit Instrument was found to significantly increase the number of patients reporting increased counselling by a clinician at the time of discharge from the hospital (clinician, 59.3 % vs. 100.0 %, X² (1, n = 49) = 11.10, p < 0.01, physician, 28.6 % vs. 76.2, X² (1, n = 49) = 10.9, p < 0.01, pharmacist 25.0 % vs. 71.4 %, X² (1, n = 49) = 10.4, p < 0.01)). Significantly, more patients had increased knowledge on drug interactions or adverse drug reactions after using the instrument (26.1 % vs. 61.9 %, P = 0.032 and 30.4 % vs. 66.7 %, P = 0.033, respectively). The 7 Domains MedLit Instrument and the schooling years significantly correlated with the knowledge of drug interactions and adverse drug reactions. Less post-intervention participants visited an emergency department within 30 days post-discharge. The 7 Domains MedLit Instrument significantly improved the patients’ medication literacy at the time of discharge from hospital.