Medication Adherence, Self-Management and Infection Prevention Teaching

Supporting Medication Adherence and Reconciliation

Medication adherence refers to the extent to which a patient takes medications correctly according to the healthcare provider's prescribed directions. In an outpatient clinic, clinical medical assistants encounter patients facing significant obstacles to adherence. Common barriers to medication adherence include high out-of-pocket costs, fear of side effects, complex dosing schedules, and forgetfulness. A medical assistant acts as an attentive communicator who helps uncover these obstacles during rooming and routine patient intake.

During medication reconciliation, the medical assistant documents the patient's reported prescription drugs, over-the-counter medications, vitamins, and herbal supplements and refers discrepancies to the provider for review. To ensure no substances are overlooked, the clinic may use a brown-bag review. The brown-bag review involves asking the patient to bring all their current medications and supplements in their original containers to the clinical appointment, allowing the medical assistant to compare what the patient actually possesses against the electronic health record.

Medical assistants should ask open-ended questions to elicit how and when a patient actually takes their prescribed medications at home. For instance, rather than asking 'Do you take your blood pressure pill every morning?', asking 'How and at what times do you take your pills during the day?' often reveals missed doses or confusion. Pill organizers, blister packs, smartphone alarms, and medication logs are standard tools recommended to help patients track daily doses.

Medical assistants reinforce provider instructions regarding whether specific medications must be taken with meals, with a full glass of water, or on an empty stomach. Patients should consult their provider before stopping a prescribed chronic medication and seek prompt medical advice if they suspect a serious adverse reaction. The medical assistant must report any patient-reported medication nonadherence or adverse drug reactions directly to the supervising provider, remembering that a medical assistant does not independently alter medication plans.