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

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.