Effectiveness of a Medication Wallet Card
Condition: Comorbidity; Medication Therapy Management; Polypharmacy
Study type: Interventional
Phase: Phase 1

Summary: 
      This study evaluates whether or not the use of a medication wallet card in patients over 70
      taking 5 or more medications promotes self-efficacy with regards to coping with illness,
      understanding medications, and staying healthy. Half of the participants will receive an
      individualized medication wallet card with their medications and medical conditions listed
      while the other half will receive a simple reminder card.
    

Detailed description: 
      In order to prevent medication errors and subsequent ADEs, a complete and accurate medication
      list must be maintained. Although electronic healthcare records, maintained by healthcare
      providers, have been praised for their potential to decrease medication errors, studies show
      that the sole implementation of a paperless system is not sufficient to eliminate medication
      recording and prescription errors. Hence, an approach to maintain complete medication lists
      will need to involve the cooperation of both health care providers and patients. A previous
      study showed that an integrated approach including all members of the healthcare team and the
      patient improved the completeness and accuracy of medication list from 7.7% to 18.5%. One way
      to increase patient involvement in medication reconciliation is by allowing the patients to
      become more informed about their health and medications.

      According to the Bandura's Social Cognitive Theory of Self-Efficacy, the beliefs a person
      holds regarding his or her power to influence situations strongly affects the agency a person
      has to face challenges capably. A tool such as an up-to-date MWC that has a list of the
      medications and dosages in addition to medical conditions listed may help older patients to
      better understand and manage their health. Furthermore, a wallet card has been an effective
      tool with many benefits. For example, a study showed that a Medication Allergy Profile card
      increased patient's knowledge of their drug regimens, decreased medication errors, decreased
      drug interactions, and improved patients' compliance.

      No randomized control trials currently show the the impact of a medication wallet card/list
      on patient enablement. One study showed that a significant percentage of the patients were
      willing to use a self-maintained wallet-sized medication list. In addition, those who used
      the medication list showed an improved sense of knowledge about their medical problems and
      medication, and also exhibited an enhanced sense of responsibility in maintaining their
      medication lists. However, the study considered a relatively young population that only
      included patients over the age of 40 and did not stipulate a minimum number of medications
      for the patients to be taking. In addition, the study was not a randomized control trial, and
      used the Patient Medication Scale (PMS) to measure outcomes.

      Hence, a randomized control trial employing a standardized questionnaires to investigate an
      older population (age greater than 70) experiencing polypharmacy is needed to asses the
      impact of a medical wallet card in promoting self efficacy and patient enablement.
    

Intervention name(s): Medication Wallet Card; Reminder Card
Intervention type(s): Device; Device
Intervention description(s): A medication wallet card will be given to the intervention group. This will be personalized for each patient and will include the patient's medications, dosages, and medical conditions. It will be personally given to a patient after a medical appointment with their family physician.; A reminder card will be given to this group. The card will not be personal and will be mailed to patients. It will state, "Remember to keep an up-to-date listing of your medications and bring your medications to your doctor's appointments."
Other intervention name(s): Placebo Intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: polypharmacy; wallet card; medication; self-efficacy; patient enablement