Implementing the Med Wise Program in rural Alberta: A feasibility study to support seniors

Abstract

Poor medication management in older adults contributes to adverse drug events, hospitalization and death and costs the health care system more than $400 million each year. This is a public health concern, for which older adults themselves can be one of the keys to the solution. However, older adults are not often knowledgeable enough to ask questions and share health decisions with their prescribers, which leads to poor health outcomes. The Med Wise program was adopted from the United States to empower older Canadians to be proactive in engaging pharmacists to help them manage their therapeutic regimens. This was hypothesized to lead to safer and more effective medication use with lower costs. The Med Wise program was the first skill-based educational and behavioural intervention designed for and led by older adults to raise awareness about pharmacists’ roles and to practise skills to enhance communication with the pharmacist. Older adults, trained as facilitators, conducted a series of group discussions on medication management and communication techniques to ask about medication concerns. Med Wise increased the likelihood that older adults would raise a medication concern with their pharmacist and obtain a medication review, a process that can contribute to the safe and effective use of medication. This program was adapted to the Alberta context by adding explanations of the Albertan pharmacist’s scope and roles, including the medication review process specific to Alberta. Med Wise focuses on increasing older adults’ awareness and access to medication supports from existing publicly funded pharmacy services in Alberta. The educational materials were trialed with 10 older adults in an older adults’ association in Edmonton before this feasibility study. In alignment with the goal of Canada’s Strategy for PatientOriented Research (SPOR), we developed a partnership between researchers at the University of Alberta and citizen members of IMAGINE Citizens Collaborating for Health. The aim was to implement Med Wise as a community-based patient-oriented program to meet community-based older adults’ needs. We chose this community partner because IMAGINE’s priorities, similar to Med Wise, include encouraging patients and families to take a partnership role in their health care. To develop a successful program, we conducted a feasibility study in 2 smaller towns approximately 300 km north of Edmonton, Alberta: Cold Lake, with a population of 15,000 residents, and Bonnyville, with 6000 residents. Feasibility studies are designed to determine if an intervention can be adapted to a new environment and answer the question, “Can it be done?” Our primary objectives were to test the feasibility of delivering the Med Wise program for seniors in rural Alberta. Specific objectives included testing the 1) demand and acceptability of the Med Wise program and 2) the acceptability and usefulness of the preand postquestionnaires to measure expectations, self-efficacy and knowledge.