What's your PLAN? A pilot study of a brief intervention to improve patient self-reported understanding of their health condition and medication in an inpatient hospital setting

Abstract

Objective: Health literacy is poor in many health service users. Although interventions exist, none have been implemented during an inpatient setting. This pilot study investigated the effect of a brief intervention, delivered by hospital pharmacists during an inpatient admission, on patient self-reported understanding of their health condition and medication-one aspect of health literacy.

Methods: Patients admitted to a tertiary hospital in New Zealand on one or more high-risk medication were included. Patients received a brief intervention discussing four steps (PLAN) to help patients: Prepare for their next health visit, Listen and share concerns, Ask questions and Note what to do next. The primary outcome was patient self-reported understanding of their health condition and medication. Secondary outcomes were number and types of pharmacist interventions, patient satisfaction and pharmacist intervention acceptability.

Results: Thirty-eight patients received the intervention. Scores improved for how well patients felt they understood their health conditions (increase from 3.65±1.16 to 4.28±0.74, P=0.027), their medication (3.50±1.11 to 4.44±0.77, P=0.001) and how to take their medication (4.12±0.95 to 4.60±0.76, P=0.051). Additional pharmacy interventions were made for 47% of patients. Mean patient satisfaction scores were high (4.64±0.57); however, pharmacist acceptability was only moderately positive with many finding the intervention only somewhat rewarding.

Conclusion: This pilot study shows that a pharmacist-delivered intervention can have an effect on an aspect of health literacy in an inpatient setting. It suggests the potential for further inpatient interventions, which target health literacy issues.

Keywords: advice-giving; clinical pharmacy; education and training; health literacy; hospital pharmacists; medicine use; patient counselling; pharmaceutical care; pharmacotherapy; quality in healthcare; therapeutics.