Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Research ArticleOriginal Research

Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit

Barry D. Weiss, Angela G. Brega, William G. LeBlanc, Natabhona M. Mabachi, Juliana Barnard, Karen Albright, Maribel Cifuentes, Cindy Brach and David R. West
The Journal of the American Board of Family Medicine January 2016, 29 (1) 18-23; DOI: https://doi.org/10.3122/jabfm.2016.01.150163
Barry D. Weiss
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Angela G. Brega
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
William G. LeBlanc
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Natabhona M. Mabachi
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
MPH, PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Juliana Barnard
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
MA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karen Albright
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Maribel Cifuentes
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
RN
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Cindy Brach
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
MPP
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David R. West
From the Department of Family and Community Medicine, University of Arizona, Tucson (BDW); the Department of Community and Behavioral Health, Colorado School of Public Health, Aurora (AGB, KA); the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (AGB, WGL, MC, DRW); the American Academy of Family Physicians, Kansas City, KS (NMM); the Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus, Aurora (JB, KA, DRW); and the Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD (CB).
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Tables

    • View popup
    Table 1. Tools/Topics Included in the Health Literacy Universal Precautions Toolkit
    How to form a team to assess the practice and raise awareness about health literacy
    Tools for improving spoken communication
        How to communicate clearly
        How to use teach-back
        Effective follow-up
        Effective phone communications
        “Brown bag” medication review
        How to address language differences
        Dealing with patients from different cultures
    Tools for improving written communication
        How to design easy-to-read material
        How to use health education material effectively
        Good signage
    Improving patient self-management and empowerment
        Encouraging patients to ask questions
        Helping patients to make action plans
        Improving medication adherence and accuracy
        Getting patient feedback
    Improving support systems
        Linking patients to nonmedical support services
        Linking patients to medication resources
        Linking patients to health and literacy resources in the community
    • Adapted from ref. 11.

    • View popup
    Table 2. Characteristics of the Two Practices That Implemented the Brown Bag Medication Review Tool
    Characteristic*Missouri PracticeCalifornia Practice
    Practice typePrivate family medicine practice; patient-centered medical homeFamily medicine residency; federally qualified community health center
    LocationRuralSuburban
    Clinicians (n)†
        Full time74
        Part time030
    Patient population (approximate n)4,70010,000
    Patient sociodemographics (%)
        Medicaid3575
        Black15
        White9510
        Hispanic279
        Age >65 years3012
        Non-English-speaking150
        Limited health literacy‡3256
    • ↵* Data on practice characteristics were provided by the individual practices.

    • ↵† Clinicians include physicians, advanced practice nurses, physician assistants.

    • ↵‡ Percentage of patents with limited health literacy was based on the Health Literacy Prevalence Calculator, which uses practice demographics to estimate the prevalence of limited health literacy among a patient population (http://surroundhealth.net/Topics/Education-and-Learning-approaches/Health-literacy/Articles/Health-literacy-A-foundation-to-effective-patient/Health-Literacy-Prevalence-Calculator.aspx).

    • View popup
    Table 3. Toolkit's Action Plan for Brown Bag Medication Review
    Ways to remind patients to bring medications
        Appointment cards
        During appointment reminder calls
        During office visits
        Posters in exam rooms and waiting rooms
        Bulletin board display of anonymous cases that make the case for bringing medications
        Emphasize that the review usually results in taking fewer medications
        Provide a carrier (bag or sack) in which patients can bring medications to visits
    What to tell patients to bring
        All prescription medications including pills and creams
        All over-the-counter medicines taken regularly
        All vitamins and supplements
        All herbal medications
    What to do during the medication review
        Offer praise for bringing the medications
    Τrack progress
        Track the percentage of patients each day who have had a medication review completed
        Aim for 90% of patients to have a review over a 12-month period
    • Adapted from ref. 11.

    • View popup
    Table 4. Comparison of Medication Reviews Performed Before and After Implementation of the Brown Bag Medication Review Tool
    Item EvaluatedBefore ImplementationAfter ImplementationP Value
    Missouri Clinic (n = 27)California Clinic (n = 18)Total (n = 45)Missouri Clinic (n = 20)California Clinic (n = 21)Total (n = 41)*
    Prescription medications brought to office visit, mean (SD)0.44 (1.9)1.8 (2.6)1.0 (2.3)8.0 (5.4)5.6 (3.4)6.8 (4.6)<.001
    Prescription medications reviewed with patient, mean (SD)3.25 (5.4)3.3 (2.4)3.3 (4.3)7.4 (4.5)4.9 (3.1)6.1 (4.0).003
    All prescription medications brought to visit (patient report)7.438.92070.066.768.3<.001
    All nonprescription medications brought to visit (patient report)11.15.99.125.014.319.5.003
    Problems found with medication regimen25.95.617.840.028.634.2.082
    Changes made to medication regimen as a result of the review25.95.617.850.033.341.5.016
    • SD, standard deviation. Data are percentages unless otherwise indicated.

PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Medicine: 29 (1)
The Journal of the American Board of Family Medicine
Vol. 29, Issue 1
January-February 2016
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
3 + 7 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit
Barry D. Weiss, Angela G. Brega, William G. LeBlanc, Natabhona M. Mabachi, Juliana Barnard, Karen Albright, Maribel Cifuentes, Cindy Brach, David R. West
The Journal of the American Board of Family Medicine Jan 2016, 29 (1) 18-23; DOI: 10.3122/jabfm.2016.01.150163

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit
Barry D. Weiss, Angela G. Brega, William G. LeBlanc, Natabhona M. Mabachi, Juliana Barnard, Karen Albright, Maribel Cifuentes, Cindy Brach, David R. West
The Journal of the American Board of Family Medicine Jan 2016, 29 (1) 18-23; DOI: 10.3122/jabfm.2016.01.150163
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Patient-physician communication on herbal medicine use during pregnancy: a systematic review and meta-analysis
  • Improving Health Literacy at the Organizational Level
  • Increasing the use of home medication lists in an outpatient neurorehabilitation clinic
  • Content Usage and the Most Frequently Read Articles of 2016
  • Family Medicine Research That Provides Compelling, Urgent Data to Improve Patient Care
  • Google Scholar

More in this TOC Section

  • Associations Between Modifiable Preconception Care Indicators and Pregnancy Outcomes
  • Perceptions and Preferences for Defining Biosimilar Products in Prescription Drug Promotion
  • Evaluating Pragmatism of Lung Cancer Screening Randomized Trials with the PRECIS-2 Tool
Show more Original Research

Similar Articles

Keywords

  • Education of Patients
  • Health Literacy
  • Medical Errors
  • Polypharmacy

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire