Document Detail


The impact of CMSA's case management adherence guidelines and guidelines training on case manager-reported behavior change.
MedLine Citation:
PMID:  17885636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE/OBJECTIVES: The Case Management Society of America (CMSA) developed evidence-based guidelines (Case Management Adherence Guidelines, CMAG) for case managers to support increased efficacy of case managers in helping patients become more adherent to medication regimens. The effort was in response to documented high levels of nonadherence, and evidence demonstrating that lack of adherence negatively impacts patient health status. The CMSA engaged in a massive training program to support case manager adoption of the CMAG tools and approaches to improve patient knowledge and motivation. This article reports on findings of a follow-up survey that evaluated case manager's use of the tools and strategies discussed in the CMAG.
PRIMARY PRACTICE SETTING(S): Seven hundred fifty case managers from all settings were trained in the use of the CMAG.
FINDINGS/CONCLUSIONS: In a follow-up survey, 42% of respondents reported that there has been a very, or fairly, significant impact of using their new skills to increase their effectiveness in helping patients reach their outcome improvement goals. In addition, 43% reported that there has been a very, or fairly, big improvement in patient adherence since they took the training, while 39% did not see a major impact. At the time of the survey (up to 1 year after training), 43% of respondents indicated that the training was very valuable; another 39% reported that it was fairly valuable. Participants continue to use the skills and information adopted in the training sessions: 26% report that they currently use at least some of the information and skills very often, while another 49% use them fairly often. Sixty-six percent of respondents indicated that they specifically use motivational interviewing to help address patient knowledge and motivation regarding medication adherence.
IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Medication adherence is a key issue in case management practice; efforts to positively impact low patient knowledge and motivation can be frustration for case managers. The CMAG offer evidence-based assessment tools to evaluate patient knowledge of medications and their motivation to adhere, and recommend the strategy of motivational interviewing to help case managers address adherence more effectively with patients. A 1-time training on the CMAG and motivational interviewing had some effect on self-reported case manager effectiveness in addressing medication adherence. Case managers appreciated the training; many reported that they continue to use skills and that they have observed changes in patient outcomes. Additional training, skill building, and reinforcement may help case managers apply CMAG and motivational interviewing effectively to support patients' adherence to medication regimens. The CMSA may continue to evaluate the impact of the CMAG and CMAG training to refine the tools and the training approach.
Authors:
Sherry L Aliotta; Jeanne Boling; Connie Commander; David Day; Liza Greenberg; Cheri Lattimer; Danielle Marshall; Susan A Rogers
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Professional case management     Volume:  12     ISSN:  1932-8087     ISO Abbreviation:  Prof Case Manag     Publication Date:    2007 Sep-Oct
Date Detail:
Created Date:  2007-09-21     Completed Date:  2007-11-29     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  101291585     Medline TA:  Prof Case Manag     Country:  United States    
Other Details:
Languages:  eng     Pagination:  288-95     Citation Subset:  N    
Affiliation:
S.A. Squared of Tennessee, Inc., Jackson, TN 38305, USA. sasquared@earthlink.net
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MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel
Case Management / organization & administration*
Clinical Competence / standards
Computer-Assisted Instruction
Drug Therapy / psychology
Education, Continuing / organization & administration*
Evidence-Based Medicine / education,  organization & administration
Follow-Up Studies
Guideline Adherence / organization & administration*
Health Knowledge, Attitudes, Practice
Health Services Needs and Demand
Humans
Inservice Training / organization & administration*
Internet
Motivation
Patient Compliance / psychology
Patient Education as Topic
Practice Guidelines as Topic*
Professional Role / psychology
Program Evaluation
Self Efficacy
Societies, Scientific
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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