1. University of Arkansas for Medical Sciences Little Rock, Arkansas
Patient Self-efficacy and Satisfaction After Medication Education Following Solid Organ Transplantation
Seth Heldenbrand, Pharm.D., Lindsey Turnbow, Pharm.D., Nalin Payakachat, Ph.D.
University of Arkansas for Medical Sciences Little Rock, Arkansas
Background
Results
Figure 1.
Figure 2.
Medication self-efficacy, or the confidence a patient feels towards administering their medication, has been linked to adherence, which is vital for solid organ transplant (SOT) patients. At our institution most kidney and liver transplant recipients are discharged in less than one week following transplantation. This leaves transplant pharmacists a small window of opportunity to educate transplant recipients about their medications. To achieve maximum benefit, transplant medication education must be intensive and effective prior to initial discharge.
Table 1. Demographics N 21
Age (yr), mean (range)
48.9 (23-65)
Male (n) 13
Race (n)
White
African American 6
Hispanic 2
Type of transplant (n)
Kidney 14
Liver 7
Counseled by (n)
Clinical specialist 12
Pharmacy student 9
p<0.05
p<0.05
p<0.05
Objectives
To determine baseline self-efficacy and satisfaction measures in solid organ transplant recipients
To identify areas for improvement of transplant medication education process
Mean composite scores
Recipient self-efficacy 4.72 ± 0.64
Recipient satisfaction 4.50 ± 0.53
Self-efficacy scores were significantly lower (p<0.05) for items relating to taking medications:
when the recipient felt nauseated
when the purpose of the medication was unknown
in the absence of medication aids
Liver transplant recipients displayed significantly higher (p<0.05) self-efficacy scores (figure 1) compared to kidney transplant recipients
Significant differences (p<0.05) in self-efficacy and satisfaction (figure 2) were observed between counseling sessions performed by the clinical specialists and fourth year pharmacy students
The lowest scoring satisfaction item regarded pain immediately following transplant surgery, but this was not significantly different from the mean
Methods
Conclusions
A prospective cross-sectional study in de novo SOT recipients who received standardized pharmacist-led medication education prior to discharge
51 item questionnaire using 5-Likert response scale
27 self-efficacy questions
24 satisfaction questions
Levels of self-efficacy and satisfaction were determined using mean composite scores with a score of 5 representing the highest level of self- efficacy and satisfaction
Descriptive and Student t-test statistics
Transplant recipients reported high self-efficacy, suggesting preparedness to self-administer their medications
Transplant recipients were highly satisfied with the transplant medication education process
Differences in liver and kidney self-efficacy illustrates the need to tailor the medication education process to meet patient-specific needs of our transplant recipients
A new process is in place to ensure student competence prior to counseling transplant recipients which may help minimizes observed differences in self-efficacy and satisfaction
Minimum competency must be met before student is eligible to counsel transplant recipients
Intensive feedback following mock counseling sessions for students
Grading rubric is currently under development for student assessment