• Barry D Weiss, Angela G Brega, William G LeBlanc, Natabhona M Mabachi, Juliana Barnard, Karen Albright, Maribel Cifuentes, Cindy Brach, and 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). bdweiss@u.arizona.edu.
• J Am Board Fam Med. 2016 Jan 1; 29 (1): 18-23.

BackgroundAlthough routine medication reviews in primary care practice are recommended to identify drug therapy problems, it is often difficult to get patients to bring all their medications to office visits. The objective of this study was to determine whether the medication review tool in the Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit can help to improve medication reviews in primary care practices.MethodsThe toolkit's "Brown Bag Medication Review" was implemented in a rural private practice in Missouri and an urban teaching practice in California. Practices recorded outcomes of medication reviews with 45 patients before toolkit implementation and then changed their medication review processes based on guidance in the toolkit. Six months later we conducted interviews with practice staff to identify changes made as a result of implementing the tool, and practices recorded outcomes of medication reviews with 41 additional patients. Data analyses compared differences in whether all medications were brought to visits, the number of medications reviewed, drug therapy problems identified, and changes in medication regimens before and after implementation.ResultsInterviews revealed that practices made the changes recommended in the toolkit to encourage patients to bring medications to office visits. Evaluation before and after implementation revealed a 3-fold increase in the percentage of patients who brought all their prescription medications and a 6-fold increase in the number of prescription medications brought to office visits. The percentage of reviews in which drug therapy problems were identified doubled, as did the percentage of medication regimens revised.ConclusionsUse of the Health Literacy Universal Precautions Toolkit can help to identify drug therapy problems.© Copyright 2016 by the American Board of Family Medicine.

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