Improving Patient Medication Management Adherence and Satisfaction

Multiple medications serve as the common standard of care in management of complications following SCI. This polypharmacy in combination with multiple care transitions increases the risks of medication errors. Given these circumstances, it is paramount that individuals with SCI to ably communicate with healthcare providers about their medications and be active partners in decision making about their long-term care. The purpose of this study is to examine the effectiveness of a new web-based educational application to assist patients and caregivers better understand their individual drug regimen in order to more fully participate in their medication management. Specifically we will determine whether: 1) the use of an innovative web-based application increase self-efficacy, medication adherence, and medication management satisfaction in individuals with SCI and 2) Is the web-based polypharmacy program more effective in persons who are recently injured versus those with chronic SCI? Studies have shown that adherence rates with oral medications treatment are very poor (10-50%). In the proposed study thirty individuals with SCI (15 acutely injured and 15 chronic), who are currently receiving medication management for secondary conditions and/or co-morbidities (e.g. hypertension, diabetes etc.) will be provided access to an new web-based application that provides the user with a color coded series of "Drug Cards" that offers easy to understand information. In addition to color coding, each drug card provides images representing the most common side effects for that medication as well as information on when to take the medication, known drug-drug interactions, and any black box warnings. There are currently over 3000 medications listed in this database including the top 100 medications most commonly used by individuals with SCI. Data that will be collected at baseline and 6 months post-enrollment in this study include: 1) demographics such as age, gender, injury type, ASIA severity score, and time post injury, 2) current list of medications, 3) the number of times medications or dosages have been changed during the study period, 4) patient reported outcomes related to self-efficacy, medication treatment satisfaction, and health literacy. In addition to the patient reported outcomes, information with respect to ease and usefulness of the web-based application will be collected.