Table 1 Overview of the Nurse-led Medication Self-management Intervention Sessions
Aim | Content | Delivery strategy |
|---|---|---|
1st face-to-face education session | ||
• To identify patients’ problems and barriers to medication adherence. • To educate patients on the right information about medication-taking and adherence. | (1) Inform patients about the purpose and procedure of the whole intervention; Rapport building. (2) A structured patient-centred adherence assessment, covering a checklist with all the questions about patients’ medication experiences, including effectiveness and side effects of the drugs, treatment burden, and barriers to adhering to medications. (3) Educate patients on disease- and medication-related information and correct misinformation, including the name, dosage, frequency, timing, purpose of each medication, potential side effects, and special administration considerations. (4) Encourage patients to ask questions and confirm patients understand what they are told. | ❖ Individualisation ❖ Teach-back technique |
2nd face-to-face education session | ||
• To help patients change negative attitudes and beliefs about medication treatments and become motivated to it. • To help patients change negative perceptions of social norms for medication-taking and facilitate a positive attitude toward social support for adherence | (1) Empower patients with knowledge about the importance of medication adherence and the consequences of nonadherence. (2) Explore patients perceived social norms of adherence and the role of social support networks in supporting medication treatments and self-care. (3) Encourage patients to express their feelings and barriers to their family members and seek help where appropriate. (4) Provide a list of local resource information to patients (e.g., medical care institutions, psychological support organisations, and peer support teams). | ❖ Motivational interviewing ❖ Mobilising social support |
3rd face-to-face education session | ||
• To help patients develop skills and strategies to overcome practical barriers of their medication treatments. • To help patients set goals and develop a workable adherence improvement plan. | (1) Nurses will educate patients about six skills in medication self-management: 1. Identifying and coping with medication side effects; 2. Incorporating medication treatments into daily life; 3. Obtaining and updating medication adherence-related information; 4. Acquiring, self-cueing and self-administering medications; 5. Effectively communicating with healthcare providers; 6. Acquiring social and instrumental support for adherence. (2) Ask patients to select three skills they most want to learn or help most to take their medications; Discuss with patients about strategies on how to apply the three skills to their self-management. (3) Set goals and help make an individualised adherence improvement plan based on patients’ expectations and preferences. | ❖ Planning coping responses ❖ Goal setting |
2 weekly follow-up phone calls | ||
• To further explore the challenges and difficulties in medication self-management. • To provide feedback and suggestions according to patients’ performance. | (1) Ask whether patients can adhere to the medications in the last week and if not, the reasons for medication nonadherence will be asked and discussed with patients. (2) Ask whether patients can apply skills in medication self-management and encounter any challenges and concerns in medication-taking. (3) Further adherence education where needed. (4) Conclude what is discussed and encourage patients to contact healthcare providers when they have adherence problems. | ❖ Active listening ❖ Personalised feedback |