Efficiency, Efficacy, and Power in the Implementation of a Medication Adherence Aid
Nonadherence to medication regimens is common, with approximately 50% of patients not taking their medications as prescribed. The Universal Medication Schedule (UMS) is a set of standardized, evidence-based, and patient-centered instructions for pill-form medications that has demonstrated improvemen...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SLACK Incorporated
2018-07-01
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| Series: | Health Literacy Research and Practice |
| Subjects: | |
| Online Access: | https://www.healio.com/public-health/journals/hlrp/2018-7-2-3/%7B29f15f8c-d260-4809-8d87-2fd29eee86b6%7D/efficiency-efficacy-and-power-in-the-implementation-of-a-medication-adherence-aid |
| _version_ | 1811251408757850112 |
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| author | Roy Cherian Urmimala Sarkar Elaine C. Khoong Sara Ackerman Gato Gourley Dean Schillinger |
| author_facet | Roy Cherian Urmimala Sarkar Elaine C. Khoong Sara Ackerman Gato Gourley Dean Schillinger |
| author_sort | Roy Cherian |
| collection | DOAJ |
| description | Nonadherence to medication regimens is common, with approximately 50% of patients not taking their medications as prescribed. The Universal Medication Schedule (UMS) is a set of standardized, evidence-based, and patient-centered instructions for pill-form medications that has demonstrated improvements in adherence by promoting patient comprehension. An urban, publicly funded, integrated health care system attempted to adopt UMS labeling but had limited success at its largest pilot site, which was a safety-net health care system's outpatient pharmacy. To assess barriers to implementation, we engaged pharmacists at this site in group interviews. We thematically analyzed transcripts by integrating sociological work on standardization with grounded theory methodologies. In addition to lacking technological infrastructure, tensions among efficiency, efficacy, and effectiveness, and tension between individual/biomedical versus population health perspectives emerged as barriers to implementation. Additionally, we discovered that hierarchies of professional power impeded uptake. For successful implementation of evidence-based practices for vulnerable populations in resource-poor settings, efforts must anticipate and reconcile the tensions among conflicting demands, professional hierarchies, and divergent orientations to patient care. |
| first_indexed | 2024-04-12T16:19:58Z |
| format | Article |
| id | doaj.art-668cad2e78dc4f2cba1ccf399a7d55e5 |
| institution | Directory Open Access Journal |
| issn | 2474-8307 |
| language | English |
| last_indexed | 2024-04-12T16:19:58Z |
| publishDate | 2018-07-01 |
| publisher | SLACK Incorporated |
| record_format | Article |
| series | Health Literacy Research and Practice |
| spelling | doaj.art-668cad2e78dc4f2cba1ccf399a7d55e52022-12-22T03:25:36ZengSLACK IncorporatedHealth Literacy Research and Practice2474-83072018-07-0123e128e13110.3928/24748307-20180525-01Efficiency, Efficacy, and Power in the Implementation of a Medication Adherence AidRoy CherianUrmimala SarkarElaine C. KhoongSara AckermanGato GourleyDean SchillingerNonadherence to medication regimens is common, with approximately 50% of patients not taking their medications as prescribed. The Universal Medication Schedule (UMS) is a set of standardized, evidence-based, and patient-centered instructions for pill-form medications that has demonstrated improvements in adherence by promoting patient comprehension. An urban, publicly funded, integrated health care system attempted to adopt UMS labeling but had limited success at its largest pilot site, which was a safety-net health care system's outpatient pharmacy. To assess barriers to implementation, we engaged pharmacists at this site in group interviews. We thematically analyzed transcripts by integrating sociological work on standardization with grounded theory methodologies. In addition to lacking technological infrastructure, tensions among efficiency, efficacy, and effectiveness, and tension between individual/biomedical versus population health perspectives emerged as barriers to implementation. Additionally, we discovered that hierarchies of professional power impeded uptake. For successful implementation of evidence-based practices for vulnerable populations in resource-poor settings, efforts must anticipate and reconcile the tensions among conflicting demands, professional hierarchies, and divergent orientations to patient care.https://www.healio.com/public-health/journals/hlrp/2018-7-2-3/%7B29f15f8c-d260-4809-8d87-2fd29eee86b6%7D/efficiency-efficacy-and-power-in-the-implementation-of-a-medication-adherence-aidmedication adherence |
| spellingShingle | Roy Cherian Urmimala Sarkar Elaine C. Khoong Sara Ackerman Gato Gourley Dean Schillinger Efficiency, Efficacy, and Power in the Implementation of a Medication Adherence Aid Health Literacy Research and Practice medication adherence |
| title | Efficiency, Efficacy, and Power in the Implementation of a Medication Adherence Aid |
| title_full | Efficiency, Efficacy, and Power in the Implementation of a Medication Adherence Aid |
| title_fullStr | Efficiency, Efficacy, and Power in the Implementation of a Medication Adherence Aid |
| title_full_unstemmed | Efficiency, Efficacy, and Power in the Implementation of a Medication Adherence Aid |
| title_short | Efficiency, Efficacy, and Power in the Implementation of a Medication Adherence Aid |
| title_sort | efficiency efficacy and power in the implementation of a medication adherence aid |
| topic | medication adherence |
| url | https://www.healio.com/public-health/journals/hlrp/2018-7-2-3/%7B29f15f8c-d260-4809-8d87-2fd29eee86b6%7D/efficiency-efficacy-and-power-in-the-implementation-of-a-medication-adherence-aid |
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