Editor, – Dr Bradley ('Your questions to the PBAC' Aust Prescr 1993;16:96) observes that it is easy to lose touch with a patient's medications because 'a complete list (is not available) ... all at one time.'
There are several ways in which patients could have such a list, with its obvious advantages. One is by using the 'Medi-List' issued by the Pharmaceutical Society of Australia and illustrated in 'Medication review: what your patients may not tell you' (Aust Prescr 1993;I6:40-2).This card has spaces for information about the individual and the medications, and folds down to a convenient pocket size similar to the pension card. Its main drawbacks are:
- the time to prepare each new card (20-30 minutes)
- transcription errors
- lack of legibility. (This can be overcome by attaching duplicate labels to the card, prepared at the point of dispensing.)
The 'Medi-List' has been used at Whyalla Hospital for some months and, after about 80 cards had been issued, an alternative method was investigated. A detailed printout of patients' medications is prepared on computer in a form similar (but not identical) to the 'Medi-List'. It is provided to selected patients on discharge, mainly those on multiple long-term treatments.
The printout is designed to be understood easily by patients and their carers, with extra attention to legibility for those with mild visual impairment. It saves handwriting and is very quick to update if any changes have been made to medication. So far, about 20 patients have been supplied, and the initial response has been favourable.
Such a small scheme may not provide all the answers to Dr Bradley's problems, but, so far, it appears to assist with many of the difficulties which patients have with compliance, and to help others involved in their care. In the next part of this project, it is planned to study in more detail how patients and others use this printout, the costs or savings that result and any consequences that may emerge.
Michael Patkin, Visiting Surgeon
Hugh Dearnley, Visiting Medical Officer
Chris Thompson, Pharmacist
Whyalla Hospital & Health Services, S.A.