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Medication Management for PPT Interviews

The document outlines topics and questions for conducting interviews with patients, focusing on medication management, adherence, administration, safety, allergies, immunizations, diet, and additional health concerns. It provides guidance for both in-person and telephone visits, emphasizing communication techniques for older adults. Additionally, it includes a disclaimer regarding parking for home visits and information on accessing translation services.

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alima110593
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16 views3 pages

Medication Management for PPT Interviews

The document outlines topics and questions for conducting interviews with patients, focusing on medication management, adherence, administration, safety, allergies, immunizations, diet, and additional health concerns. It provides guidance for both in-person and telephone visits, emphasizing communication techniques for older adults. Additionally, it includes a disclaimer regarding parking for home visits and information on accessing translation services.

Uploaded by

alima110593
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Topics/Questions for PPT Interviews

Note: we do not typically ask our PPTs what their maintenance medications are used for.
We do not expect them to keep track of that, so please do not quiz them on medication
indications. Rather, you can say, “I have your medication list, and you take lisinopril and
metoprolol succinate to lower your blood pressure and protect your heart. Do you ever
feel dizzy from these medications?”

● Medication storage/supply
○ Home visits: ask the PPT to show you all of their medications, supplements,
inhalers, insulin pens/syringes, OTCs, pillboxes, etc. and where they are stored.
○ Clinic visits: ask the PPT to show you any as-needed/rescue medications they
carry (or should be carrying) such as rescue inhalers, Epi-Pen, nitroglycerin,
and/or naloxone.
○ Confirm how the PPT receives their maintenance medications - i.e., blister packs,
medication pouches, or vials. As-needed oral medications are delivered in vials.
Some PPTs receive a weekly pillbox (cassette) from PACE and others have their
maintenance medications loaded into an MD2 dispenser by their PACE home
care nurse.

● Medication adherence
○ How do they remember to take their medications?
○ If they miss doses, which medications and how often and why?
○ PRN medications: how often do they use them, do the medications work for
them, do they know the indication for each PRN medication.
○ Are there any medications they have decided to stop taking, and why?

● Medication administration
○ Ask them to show you how they use maintenance/acute inhalers using their
actual inhalers and/or demo inhalers (without inhaling).
○ Insulin/injectables: ask where they are injecting, are they rotating sites, any
difficulties with drawing up or dialing the dose.

● Medication safety and falls risk


○ Ask about general side effects, i.e., if they take several central nervous system
medications, you can ask if they feel tired, confused, or drowsy.
○ If they are taking antiplatelets and/or anticoagulants, do they notice unusual
bleeding and/or bruising?
○ Ask if they have had any falls in the past six months.
○ Can ask additional questions related to falls risk such as whether they know how
to safely get up from bed or a chair to avoid dizziness; whether they have stairs
in their home; whether they have any difficulty walking and/or use durable
medical equipment to ambulate such as cane, walker, or Rollator.
● Medication allergies/intolerance
○ Confirm list in electronic health record (EHR) and/or ask about reactions.
○ If there is no reaction listed in the EHR and they cannot remember the reaction,
let me know, and I’ll make a note.

● Immunizations
○ Ask whether they are interested in receiving any vaccines they are due for, and if
so, we can let Curtis know.
○ If they have previously refused vaccines, you can ask whether they are willing to
share why and remind them if they change their mind, to let us know.

● PPT questions/concerns
○ Ask if they have any questions or concerns about their medications.
○ Do not make any promises about medication changes; let them know we will
pass along their concerns/questions to their PCP.

● Diet
○ Our dietitians will ask PPTs for a 24-hour recall of food so you can read the most
recent Nutrition (Re)Assessment in PrimeSuite to have an idea of what the PPT
might tell you; you might want to ask about daily quantities as well.

○ If you make any suggestions regarding diet for cardiovascular conditions,


diabetes, etc., keep in mind that our PPTs may be affected by a lower
socioeconomic status and/or may not have a lot of healthy food places nearby.

○ Congratulate PPTs on any healthy food choices they are making.

● Additional non-medication topics


○ Exercise (with functional abilities in mind).
○ Smoking cessation interest.
○ Sleep changes.
○ Pain control.
Guidance for Telephone Visits
● Use a PACE phone in an available clinic room.
● Introduce yourself as a pharmacy student working with PACE.
● Ask if the PPT or caregiver has time to talk now or if you should call back (and when).
● Let the PPT or caregiver know you’d like to review medications, see if they have any
concerns or questions, how often they use PRN medications, etc.
● When speaking with older adults…
○ Speak in a clear voice at appropriate volume
○ Enunciate
○ Listen actively
○ Avoid interrupting patient
○ Be aware of tone of your voice and theirs
○ Use layman’s terms
○ Eliminate background noise
○ Smile while speaking (if appropriate)
○ Use open ended-questions and motivational interviewing
○ Avoid putting the call on speaker
○ Talk in a quiet environment

*Disclaimer regarding home visits: please be sure you are parking in appropriate places,
based on individual residential or building rules. You can ask the PACE team member for a
parking sign to print and take with you. Some residential buildings do not allow you to park in
their lots (or require the participant to alert them in advance, which does not always happen)
and you will need to use street parking. If you attend a home visit for the Family Care Center
with Dr. Hume, you may be able to carpool with a team member.

Certified Languages International:

Language line 1-800-225-5254; code is 225pace. Your name, patient name (first and last), and
language spoken.

They may ask for our phone number which is 401-434-1400.

Common questions

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To assess and improve medication adherence among patients with multiple chronic conditions, healthcare providers should utilize a combination of strategies that include regular medication reviews, personalized adherence plans, and robust communication methods such as motivational interviewing . Assessing barriers to adherence, such as socio-economic factors or complex medication regimens, allows for tailored interventions. Encouraging the use of medication management tools, like pillboxes or automated dispensers, can simplify complex regimens and enhance adherence . Regular follow-up visits or check-ins can help address new adherence challenges promptly .

Healthcare providers can ensure medication adherence in patients by discussing and reviewing the patient's routine, asking how they remember to take their medications, addressing any missed doses, and understanding the frequency of PRN medication usage . Additionally, understanding the patient's method of receiving medications, such as blister packs or pillboxes, can help in identifying adherence issues . Integrating motivational interviewing techniques and active listening can further enhance adherence by engaging the patient in meaningful conversation .

Socioeconomic status can significantly influence dietary recommendations for patients using PACE services, as limited incomes and accessibility to affordable healthy foods can restrict dietary options . When making dietary suggestions, it's vital to consider these financial constraints and the availability of resources like local food markets or food assistance programs. Recommending practical and affordable dietary choices can help ensure that patients are able to adhere to nutritional advice despite socioeconomic challenges .

When approaching the topic of smoking cessation with PACE participants, healthcare providers should use motivational interviewing to explore the participant's readiness to quit, their motivation levels, and any previous cessation attempts . Providing information about the health benefits of quitting smoking and offering resources like cessation programs or aids can support participants in their journey to quit. It's important to acknowledge challenges related to smoking cessation and provide encouragement while respecting the participant’s autonomy in decision-making .

When discussing exercise options with PACE participants, it is crucial to consider their functional abilities and limitations . Tailor exercise recommendations to accommodate any physical restrictions, ensuring that suggestions are realistic and safe for their current health status. Additionally, socioeconomic factors and accessibility of exercise facilities should be taken into account, as these can significantly impact a participant's capacity to engage in physical activity .

Healthcare providers should confirm medication allergies and intolerances by checking the electronic health record (EHR) and asking participants about any reactions experienced . If no reaction is listed in the EHR and the participant cannot recall the reaction, noting this discrepancy allows for further investigation. Providers should educate participants on recognizing symptoms of allergic reactions, ensuring they understand the importance of reporting new allergies promptly .

When inquiring about a patient's willingness to receive vaccines, it is important to understand their past decisions regarding vaccinations, as well as any concerns or misconceptions they may have . Providing clear and factual information about the benefits and potential risks of vaccines can address hesitancy. Moreover, respecting the patient's autonomy and decision-making process is crucial, while also reminding them that they can reconsider their decision at any time .

Healthcare providers can assess a PACE participant's risk of falls by inquiring about recent falls within the past six months, evaluating the use of medications such as antiplatelets and anticoagulants that might increase bleeding risks, and assessing the patient's home environment for fall hazards like stairs . Additionally, observing the participant's mobility and whether they use assistive devices, as well as assessing their ability to rise safely from bed or chairs, can provide valuable insight into fall risks .

For telephone visits with PACE participants, it is important to introduce oneself clearly, verify if it is a convenient time for the patient or caregiver to talk, and explain the purpose of the call about medication review and any questions or concerns they might have . Speaking clearly, enunciating words, using a calm tone, and avoiding interruptions are key communication strategies. Using open-ended questions encourages participants to share their concerns while minimizing distractions like background noise enhances the call's effectiveness .

Critical safety considerations for patients taking central nervous system medications include monitoring for side effects such as tiredness, confusion, or drowsiness, all of which can increase the risk of falls . It is also essential to assess the patient's understanding of how to safely get up from a bed or chair to avoid dizziness and to evaluate their home environment for potential fall hazards like stairs . Ensuring the patient uses appropriate assistive devices, such as walkers or canes, can further mitigate fall risks .

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