Abstract
In hospital, healthcare providers usually manage medication for patients although patients are expected to self-manage their medication after discharge. A lack of self-management competencies is found to be associated with low adherence levels and medication errors harming patients' health. Approximately 50% of patients afflicted by chronic conditions do not adhere to prescribed medication regimens. When self-management is allowed during hospitalization, it rarely is provided using a structured, evidence based format. Medication self-management is considered to be a promising strategy to optimize adherence rates. To date, however, empirical data demonstrating the effect of medication self-management on patient adherence is lacking. The proposed PhD project will: 1) develop and evaluate an evidence-based guideline for healthcare providers supporting patients with medication self-management problems; 2) explore medication-related shared decision making as a supportive measure in medication self-management; 3) assess the feasibility and applicability of a combined set of tools measuring medication adherence to polypharmacy from a longitudinal perspective; 4) evaluate the effect of structured medication self-management (i.e., SelfMED) on medication adherence after discharge. Using a stepped wedge trial design, the effect of the SelfMED-intervention will be compared to usual care in hospitalized patients with polypharmacy.
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