The Effect of Medication Self-Management During Hospitalisation (SelfMED) on Medication Adherence Post-Discharge in Oncology Patients with Polypharmacy: A Prospective, Exploratory, Single-Centre, Non-Randomised Pre–Post Intervention Study with Sequential Control and Intervention Cohorts

Abstract

Objectives: To evaluate the effect of in-hospital medication self-management (SelfMED) on medication adherence two months post-discharge in polymedicated oncology patients. Methods: A prospective, exploratory, single-centre non-randomised pre–post intervention study with sequential control and intervention cohorts was conducted. During a five-month control phase, patients received usual care, in which medication was managed by healthcare providers. In the subsequent five-month intervention phase, patients self-managed their medication during hospitalisation using the SelfMED procedure. SelfMED consists of: (1) an eligibility assessment for self-management, (2) a monitoring tool to follow up medication intake and detect problems and (3) a support tool for healthcare providers to assist patients with problems. Medication adherence was assessed two months post-discharge using pill counts and self-report. Secondary outcomes included self-management problems, medication knowledge, patient and healthcare provider satisfaction, workload and healthcare service utilisation. Results: Sixty-four patients completed the study (control: n = 34; intervention: n = 30). Two months post-discharge, patients in the intervention group were, on average, adherent to 74.5% of their prescribed medications, versus 59.1% in the control group (difference 15.4 percentage points; 95% CI −0.8 to 31.7). This difference was not statistically significant (p = 0.062). Patients in the intervention group reported fewer medication self-management problems in their diaries (3.3% vs. 26.5%, p = 0.015) and more often felt adequately prepared for medication self-management at home (93.1% vs. 71.4%, p = 0.041). No differences were observed in medication knowledge, healthcare service utilisation, or workload. Conclusions: SelfMED did not significantly improve medication adherence after discharge but may support patients’ preparedness for medication self-management at home. Given the small achieved sample size, these findings should be regarded as exploratory. Studies with larger samples and more diverse populations are needed to confirm these findings.

The authors' abstract, as published at the source. Healthcare, 2026 · DOI ↗