OCCUPATIONAL THERAPY AND MEDICATION MANAGEMENT
Occupational therapists contribute to medication management by identifying problems that make it difficult for patients to adhere to medication routines and by helping them integrate medication administration into their daily life routines. Therapists can also address concerns over safety and performance skill that may be altered by medication side effects.
In inpatient settings, occupational therapists address medication management by issuing adaptive equipment, training patients and/or caregivers, and working with patients to optimize their daily schedules based on medication effects. Occupational therapists develop new routines and provide external cues, such as using large charts or calendars with written reminders or training clients to use medication reminder alarms upon returning home following discharge (AOTA, 2018).
In all settings of care, occupational therapists can develop a patient-centered care plan that provides:
- Health literacy interventions to improve a patient’s ability to understand complicated health information
- Support to other team members in creating effective patient education
- Assessment of a patient’s performance of medication-related skills to identify the risk of nonadherence and recommend measures to reduce the risks
- Interventions to ensure a patient’s medications are being taken as prescribed
- Monitoring of patients’ responses to treatment while performing everyday activities
Medication management has historically been considered the domain of physicians, nurses, and pharmacists. However, none of these specifically address a patient’s ability to manage medications as a daily occupation.
Medication management is a complex daily living activity, requiring a multidisciplinary approach that includes prescribers, nurses, pharmacists, occupational therapists, and related technicians and assistants. The goal of medication management is to assist patients in attaining perfect or near-perfect medication adherence. Adherence involves filling and refilling a prescription on time and taking a medication on schedule and as prescribed.
However, a review of occupational therapy professional literature fails to offer in-depth discussion of medication management, and a recent survey of occupational therapists demonstrated little consensus concerning their role in medication adherence, suggesting that this important activity of daily living is being overlooked.
Medication management is a service in great demand among geriatric patients, mental health patients, and children and their families, many of whom may be under an occupational therapist’s care. Each person’s nonadherence is the result of a unique set of factors, many of which are responsive to occupational therapy intervention.
Studies have shown that, although OTs have strong practice skills in improving health literacy, prescribing assistive technology, creating cueing systems, and developing supportive environments, they lack knowledge and skills specific to pharmacology, which has not traditionally been part of the OT curriculum. It is recommended that new and experienced OTs obtain the education required to better understand medications (types, drug actions, and interactions) and the profession’s scope of practice regarding them (Schwartz, 2015; Schwartz & Smith, 2017).