Research has shown that patients need information about several medication-related topics, no matter what the medication. A well-informed patient and/or family can help prevent medication errors by hospital staff and is less likely to make medication errors at home. Adherence to the medication regimen is another goal achieved through patient education.

Before beginning any teaching, however, always assess the patient’s current knowledge by asking if he or she is familiar with the medication, how it is taken at home, what precautions or follow-up care is required, and other questions specific to each drug. Based on the patient’s current knowledge level and taking into consideration factors such as readiness to learn, environmental and social barriers to learning or adherence, and cultural factors, discuss the following:

• Generic and brand names of the medication. Patients should know both the brand and generic names of each medication for two reasons. It helps them identify their medications when a generic equivalent is substituted for a brand name version, and it prevents patients or health care providers from making sound-alike confusion errors when giving or documenting a medication history. An example of this is saying Celebrex but meaning or hearing Cerebyx.
• Purpose of the medication. Patients have a right to know what the therapeutic benefit of the medication will be but also should be told the consequences of not taking the prescribed medication. This may enhance adherence. For example, a patient may be more likely to take blood pressure medication if told lowering high blood pressure will prevent heart attack, kidney disease, or stroke, rather than saying only that it will lower blood pressure.
• Dose and how to take the medication. To derive benefit and avoid adverse reactions or other poor outcomes, the patient must know how much of the medication to take and when to take it. Refer to doses in metric weight (i.e., milligram, gram) rather than dosage unit (tablet) or volume (1 teaspoon). The patient must also be informed of the best time to take the medication, for example, on an empty or a full stomach, before bedtime, or with or without other medications. If possible, help the patient fit the medication schedule into his or her own schedule, so that taking the medication is not difficult or forgotten.
• What to do if a dose is missed. Always explain to patients what to do if a dose is missed. Patients have reported taking a double dose of medication when a missed dose occurs, putting themselves at risk for side effects and adverse reactions.
• Duration of therapy. It is not uncommon for patients to stop taking a medication when they feel better or to discontinue a medication when they cannot perceive a benefit. For very long term, even lifelong therapy, the patient may need to be reminded that the medication helps maintain the current level of wellness. Patients may need to be reminded to finish short-term courses of medications even though they frequently will feel much better before the prescription runs out. Some medications cannot be discontinued abruptly, and patients should be warned to consult a health care professional before discontinuing such agents. Patients will need to know to refill prescriptions several days before running out or to take extra medication if traveling.
• Minor side effects and what to do if they occur. Inform the patient that all medications have potential side effects. Explain the most common side effects associated with the medication and how to avoid or manage them if they occur. An informed patient is less likely to stop taking a medication because of a minor and potentially avoidable side effect.
• Serious side effects and what to do if they occur. Inform the patient of the possibility of serious side effects. Describe signs and symptoms associated with serious side effects, and tell the patient to immediately inform a health care professional should they occur. Tell the patient to call before the next dose of the medication is scheduled and to not assume that the medication is the source of the symptom and prematurely discontinue it.
• Medications to avoid. Drug-drug interactions can dampen drug effects, enhance drug effects, or cause life-threatening adverse events such as cardiac dysrhythmias, hepatitis, renal failure, or internal bleeding. The patient and family need to know which other medications, including which over-the-counter medications, to avoid.
• Foods to avoid and other precautions. Food-drug interactions are not uncommon and can have effects similar to drug-drug interactions. Excessive sun exposure resulting in severe dermal reactions is not uncommon and represents an environmental-drug interaction. Likewise, the patient should be informed of what activities to avoid, in case the medication affects alertness or coordination, for example.
• How to store the medication: Medications must be stored properly to maintain potency. Most medications should not be stored in the bathroom medicine cabinet because of excess heat and humidity. In addition, thoughtful storage practices, such as separating two family members’ medications, can prevent mix-ups and inadvertent accessibility by children (or pets). Some medications, such as those with potential for abuse, must be kept in a safe/locked container away from children or others. Review storage with patients and ask about current methods for storing medications.
• Follow-up care. Anyone taking medication requires ongoing care to assess effectiveness and appropriateness of medications. Many medications require invasive and noninvasive testing to monitor blood levels; hematopoietic, hepatic, or renal function; or other effects on other body systems. Ongoing medical evaluation may result in dosage adjustments, change in medication, or discontinuation of medication.
• What not to take. Inform patients not to take expired medications or someone else’s medication. Warn them not to self-medicate with older, no-longer-used prescriptions even if the remaining supply is not expired. Tell patients to keep a current record of all medications taken and to ask health care providers if new medications are meant to replace a current medication.

As you teach, encourage the patient and the family to ask questions. Providing feedback about medication questions will increase their understanding and help you identify areas that need reinforcement. Also, ask patients to repeat what you have said and return to demonstrate application or administration techniques.

Stress the importance of concurrent therapies. Medications often are only a part of a recommended therapy. Review with the patient and family other measures that will enhance or maintain health. Always consider the cultural context in which health information is provided and plan accordingly. This might include obtaining a same-gender translator or adjusting dosing times to avoid conflict with traditional rituals.

Finally, provide written instructions in a simple and easy-to-read format. Keep in mind that most health care information is written at a 10th grade reading level, while many patients read at a 5th grade level. Tell patients to keep the written instructions, so that they can be reviewed at home, when stress levels are lower and practical difficulties in maintaining the medication plan are known.