The medication experience: Preliminary evidence of its value for patient education and counseling on chronic medications Sarah J. Shoemaker a, *, Djenane Ramalho de Oliveira b , Mateus Alves c , Molly Ekstrand b a Abt Associates Inc., Health Policy Practice, Cambridge, USA b Fairview Pharmacy Services, Minneapolis, USA c University of Minnesota, Department of Pharmaceutical Care and Health Systems, Minneapolis, USA 1. Introduction Medications are the most common therapeutic intervention used in health care and prescription drugs represent a significant portion of health care expenditures. In 2005, prescription drugs represented about 20.8 percent of all medical expenditures for persons under age 65 in the United States [1]. In 2006, 71 percent of physician office visits involved at least one prescription [2]. Moreover, drug-related morbidity and mortality costs are esti- mated at almost $200 billion annually, exceeding the amount spent on the medications themselves [3–5]. Studies have found that 32 percent of adverse events leading to hospital admission were attributed to medications [6], and that drug interactions are an important problem in medication use [7]. Studies have estimated that only 33–50 percent of patients with chronic conditions completely adhere to prescribed medications [8,9]. Despite the problems associated with medication use, when well utilized, medications can have a positive impact on the health of individuals and a population. To ensure medications are used effectively and safely, scholars in pharmacy developed a care model called pharmaceutical care, which utilizes the pharmacotherapeutic expertise of pharmacists [10–13]. Pharmaceutical care is a patient-centered practice model in which the pharmacist works directly with a patient and in conjunction with other practitioners to take responsibility for achieving the intended outcomes of drug therapy. It involves the development of an individualized care plan to achieve the intended goals of therapy with appropriate follow-up to determine actual patient outcomes [14,15]. Another key component of pharmaceu- tical care and medication therapy management (MTM) is providing education and counseling on medications to patients. Pharmaceu- tical care was first defined in 1990 and has since been accepted as the mission of the profession of pharmacy throughout the world [16–26]. In the United States, this model, has become known as Patient Education and Counseling xxx (2011) xxx–xxx ARTICLE INFO Article history: Received 1 December 2010 Received in revised form 3 February 2011 Accepted 9 February 2011 Keywords: Medication experience Pharmacy Medication therapy management (MTM) Medication education Medication counseling Medication management Drug therapy problems ABSTRACT Objective: To describe medication therapy management (MTM) pharmacists’ encounters with patients’ medication experiences, to examine the utility of the medication experience in practice, and to explore the value of the medication experience in patient education and counseling on medications. Methods: A focus group of 10 MTM pharmacists, and 1 pharmacist’s 9-month practice diary were analyzed to reveal patients’ medication experiences and the utility and value of the medication experience in practice. Results: MTM pharmacists commonly encountered patients’ medication experiences in their practices. The medication experience was often at the root of drug therapy problems (DTPs) the practitioners identified. The pharmacists identified several examples of drug therapy problems with an associated medication experience at the root. The medication experience was a meaningful construct to guide patient education and counseling on new chronic medications to ultimately prevent DTPs, and valuable for tailoring patient education and counseling on medications to resolve DTPs. Conclusion: Our study provides preliminary evidence of the value of the medication experience for patient education and counseling on chronic medications in practice. Practice implications: The medication experience is a valuable tool for practitioners to understand patients’ needs, identify and resolve DTPs, and tailor patient education and counseling for chronic medications. ß 2011 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138, USA. Tel.: +1 617 349 2472; fax: +1 617 386 7638. E-mail addresses: sarah_shoemaker@abtassoc.c, sarahjshoemaker@gmail.comom (S.J. Shoemaker). G Model PEC-3994; No. of Pages 8 Please cite this article in press as: Shoemaker SJ, et al. The medication experience: Preliminary evidence of its value for patient education and counseling on chronic medications. Patient Educ Couns (2011), doi:10.1016/j.pec.2011.02.007 Contents lists available at ScienceDirect Patient Education and Counseling journal homepage: www.elsevier.com/locate/pateducou 0738-3991/$ – see front matter ß 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.pec.2011.02.007