SIGNIFICANCE: Poor medication adherence affects about half of the 133 million Americans with chronic health conditions, causing them to experience worse outcomes, hospitalizations, disability, and even death (Schwartz & Smith, 2014). With the implementation of the Patient Protection and Affordable Care Act of 2010, much of $100 billion spent yearly on nonadherence will be shifting to providers, meaning that stakeholders are ready to address this crisis (Fisher & Friesema, 2013; Lewis, 1997).

Occupational therapists (OTs) can enable clients with chronic conditions to improve medication adherence through the implementation of better medication management (MM) strategies (American Occupational Therapy Association [AOTA], 2014). Although the role and the need for services are clear, it is undocumented how OTs actually provide MM services in current practice.

PURPOSE: The purpose of this research study was to better understand how OTs working in adult physical rehabilitation settings address MM and what factors affect their ability to provide services as desired. By understanding current service provision, researchers will be able to decipher what changes are needed within the profession to address this societal need.

METHOD: In this study, we used a mixed-methods approach involving surveys and interviews. All participants were required to be OTs practicing in an adult physical rehabilitation setting. Interview participants were required to be present at the 2014 AOTA Conference. Seventy OTs answered the invitation to complete the survey posted on various OT websites. The OTs completed the computer-assisted online survey at their leisure. With a maximum of 20 items, the survey inquired about demographics, evaluation, and intervention practices. Eight OTs also completed an interview at the 2014 AOTA Conference. The interview questioning mirrored the survey but was modified to open-ended questions. Interviews were recorded and transcribed.

RESULTS: We analyzed the multiple choice survey data using descriptive statistics to explore current trends in the field. Interview transcripts were analyzed in Dedoose (SocioCultural Research Consultants, 2012) using a grounded theory methodology. Of the survey respondents, 35% evaluated MM, and 21% engaged in intervention. Evaluation and intervention strategies varied greatly between practitioners. Four themes emerged as barriers to practice: (1) one’s beliefs about MM, (2) lack of knowledge, (3) lack of time, and (4) limited resources.

CONCLUSION: Few OTs incorporate MM into their day-to-day practice. To meet society’s needs, OTs must provide MM services, and researchers should further study and help improve the quality of the OT’s standard of care in MM. Training programs should add MM to their instruction.

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. http://dx.doi.org/10.5014/ajot.2014.682006

Fisher, G., & Friesema, J. (2013). Health Policy Perspectives—Implications of the Affordable Care Act for occupational therapy practitioners providing services to Medicare recipients. American Journal of Occupational Therapy, 67, 502–506. http://dx.doi.org/10.5014/ajot.2013.675002

Lewis, A. (1997). Non-compliance: A $100 billion problem. Remington Report, 5, 14–15.

Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 1025 (2010).

Schwartz, J. K., & Smith, R. O. (2014, June). A critical review of assistive technology in medication management assessment and intervention. Paper presented at the annual meeting of the Rehabilitation Engineering and Assistive Technology Society, Indianapolis, IN.

SocioCultural Research Consultants. (2012). Dedoose: Web application for managing, analyzing, and presenting qualitative and mixed method data [Computer software]. Los Angeles: Author.