A3

Patients/Caregivers

“I have diabetes, and thankfully, my children and I have met with my primary care doctor. He’s in touch with my pharmacist where I go to fill my prescriptions. They’re important people on my healthcare team and are helping me keep track of all my medicines – it’s not easy! But now I know when to take my pills, how often I need insulin shots and what to do if I get confused. My goal is to take my medicine, stay out of the hospital and enjoy my family – and with my healthcare team’s support, I’m doing just that!”

A3 Recommendations Advocate For…What You Can Do…
Establishing medicine adherence as a priority goal of all federal and state efforts designed to reduce the burden of multiple chronic conditions.
  • Don’t be silent! Talk with your healthcare providers about the challenges you face as you address your chronic conditions. Remind them that you see several doctors who have you taking several different medicines. Explain that you sometimes have difficulty understanding and keeping track of everything you need to do, and that you need strategies to help you stay organized.
Establishing the role of the patient navigator within the care team to help patients with multiple chronic conditions navigate the healthcare system and take their prescription medicines as prescribed.
  • Ask your primary care physician to act as your advocate. That way, one person or practice will be responsible for ensuring that all of your chronic conditions and treatment regimens are being tracked and addressed.
  • Under Medicare’s Medication Therapy Management (MTM) Program, pharmacists or other healthcare professionals can fulfill this patient navigation role. Consider this option as well.
Promoting clinical management approaches that are tailored to the specific needs and circumstances of individuals with multiple chronic conditions.
  • If you are taking several medications, work with your healthcare providers to develop a strategy that helps you track your medicine doses. It could be as simple as purchasing a special pill box that allows you to organize your daily medicines in the order that you need to take them.
  • Before you go to the doctor, put together a list of questions about your medical conditions, medication regimens, side effects and any issues that may prevent you from taking medications as prescribed. Review and use Make Notes & Take Notes to Avoid Medication Errors to help you organize your thoughts.
  • Make a list of the medications you are taking and update it regularly. Provide a copy to your primary healthcare provider, caregiver and pharmacist. Review it with this healthcare team to ensure that everyone is “talking from the same script.” You can use this Medicine Worksheet to get you started.
Incentivizing the entire healthcare system to incorporate adherence education and medication support as part of their routine care for multiple chronic conditions (MCC) patients.
  • If you have concerns about the safety and risks associated with specific medicines, talk with your doctor or other healthcare providers.
  • If you or someone you are taking care of has trouble understanding doctor instructions, find someone who can help translate or explain the instructions to you. Perhaps this person could even come with you on doctor visits.
  • If you or a loved one is leaving the hospital, make sure that you obtain clear instructions about the medications that will be stopped and those that will be started. Check out the Discharge Preparation Checklist – it’s a free download!
  • Confirm with your pharmacist about whether he/she can counsel you on appropriate medicine use. Seventy-five percent of all states in the US have enacted legislation or modified state pharmacy practice regulations confirming the role of pharmacists in providing medication therapy management services such as this.
Eliminating the barriers that impede the ability of patients with multiple chronic conditions to refill their prescription medicines.
  • Talk with your doctor and pharmacist to see whether you can schedule the timing of when and where you obtain your medications. You can start by selecting one pharmacy to be the primary location to pick up all of your medicines.
  • If you are enrolled in Medicare Part D, check on when you can take advantage of the medication discounts that you are eligible to receive during the “donut hole” [see Patient Protection and Affordable Care Act (ACA)]. Also check out NCPIE’s information on Prescription Assistance Programs.
Accelerating the adoption of new health information technologies that promote medication adherence.
  • To help you keep track of your medication regimens and refill schedules, talk with your doctor and pharmacist to see what adherence aids or electronic devices they can recommend – including iPhone apps, e-mail reminders and text message and electronic voice mail reminders. If electronics isn’t your thing, ask your healthcare providers to use postcards or phone reminders.
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