Summary: Improving Medication Adherence

While the United States has some of the best doctors and healthcare facilities in the world we fail at being efficient and effective. Currently there are too many unplanned readmissions, medication errors and hospital acquired infections. The United States health system does not effectively provide preventive medicine for individuals with chronic diseases, and this portion of health care consumers account for the majority of health care costs (Kocher et al., 2010).

The goal of Discounted MEDS is to reduce readmission rates to show that patients are healthier (Gagnon, personal communication, March 23, 2015). According to the statistics, CRH’s best readmissions percentages occurred after the program’s implementation. Nurses are giving more Discounted MEDS education in groups, which encourages patient-centered care. Therefore, patients are informed and can ask about medication costs in geographic areas. The first quarter comparison exceeded the staff’s expectations. The manager and staff analyzed and adjusted to the program needs by using the plan, do, study, and act (PDSA).

A hospital readmission is defined as one that occurs when a patient is admitted to a hospital within a specified time period after being discharged from an earlier (initial) hospitalization. For Medicare, this time period is defined as 30 days. Some of the quality care issues arise within the hospital among staff and also at home after patient discharge. Some of the highest rates of readmission within the 30 days are related to some of the following factors: complications from treatments during a hospital stay, inadequate treatment/inadequate care, coordination and follow up care at home and unexpected worsening of the disease after discharge from the hospital. Patients often face challenges with medication compliance and administration, not understanding the nature of their disease, and also where to get their questions answered once at home. The health care system has come to the conclusion that most of these issues is the leading factor in patient readmission. The most cost efficient solution to the problem of avoidable readmissions is patient education and after discharge follow up. Providing discharge instruction pamphlets to patients is not adequate enough information to yield results. Often times it is left with the patient’s belongings in a bag and never read. This gap in quality care is costing hospitals

According to the 56 resident post-Target surveys, 100% of the residents rated their current understanding of : 1) what their medication(s) are used for, 2) how to take their medication(s), 3) how to store their medication(s) and 4) how to dispose of their medication(s) as good or very good at the conclusion of the TARGET program. Ninety-three percent of the residents at the end of the program, rated their current understanding of what side effects to watch for when taking their medication(s) as good or very good; a 55% increase from the pre-Target survey. Eighty-seven percent of the residents at the conclusion of the program, rated their current understanding of how to monitor how well their medication(s) are working as good or very good; a

In order to evaluate and compare medication compliance the patient’s discharge medication reconciliation were compared to patient’s medication list at time of first office visit. Of the patients in population 1 (N=82), 71 were seen back for follow up and 11 never returned. Of the 71 that returned for follow up 97.18% (N=69) were compliant with discharged core measure medications. Population 2 (N=104), 97 were seen back for follow up with 7 never returned. Of the 97 seen back for office follow up 100% (N=97) were compliant with discharged core measure medications. Statistical analysis of the two population did not find a statistically significant difference (p= 0.0991).

As we care for our patients in a hospital settings, our goal is to get them better so that they can be discharged. Most of the time recovery continues at home or at another facility. With shorter stays in the hospital setting, the recovery at home requires increased nursing and caregiver interventions. Based on statistics published by the Center for Medicare and Medicaid Services (CMS), the rate for readmission, within the first 30 days of discharge, in 2012, for Medicare FFS (Fee-for-service) beneficiaries, averaged 18.4 percent (Gerhardt et al., 2013). Throughout this paper, readmission refers to a “return hospitalization to an acute hospital following a prior acute admission within

Good job on your project so far. Management of chronic illnesses is necessary to reduce readmissions. A major contributor of health care cost is high numbers of hospital readmissions, especially for people with chronic illness such as diabetes. Post discharge interventions such as telephone reminders by trained individual who asked patients are they taking their medication? Educating patients about treatment plan, how to detect warning signs, monitoring of blood glucose and self-management (2014).

One of the leading concerns affecting the health care system is the high rates of unplanned hospital readmissions. While some readmissions are an appropriate part of treatment, many patients are admitted back into the hospitals due to avoidable factors that compromised their health. This critical issue, according to the Dartmouth Atlas Project, has now become a measure of the quality of hospital care. As a result, the Center for Medicaid and Medicare Services (CMS) currently penalizes hospitals with high rates of 30-day readmissions for certain conditions (PerryUndem Research & Communications, 2013). Aside from the governmental costs, those most affected are the patients, families, and their providers. Effective programs assessing the discharge plan and care coordination must be enforced to diminish the number of hospital readmissions and potential health complications.

Preventable hospital readmissions remain among one of the many serious quality issues plaguing the healthcare industry today. Readmissions can carry fiscal implications, impact patient safety, and outcomes of care (Helm, Alaeddini, Bretthauer, & Skolarus, 2016). The cost of unplanned hospital readmissions is estimated to be upwards of $15 billion dollars annually of which $12 billion has been associated with preventable admissions (Helm et al., 2016). It is highly recognized that as many as 20% of Medicare beneficiaries are presently being readmitted within 30 days of discharge (Hunter, Nelson, & Birmingham,

Medication adherence is described as the extent to which the patients take medication as prescribed by the health care provider. To ensure the patients receive proper care, health care systems must implement procedures to successfully meet their needs and overall improve their quality of life. However, there are several reasons that affect proper medical care, which ultimately results in an increase in health care expenses and poorer health outcomes for patients. Studies have shown that approximately 50% of patients do not take their chronic medications as prescribed and that nonadherence can cost the health care system nearly $100 to $289 billion per year (1). Medication adherence is difficult to achieve due to ineffective communication between

It was confirmed through the study that online use of patient portals for refilling can contribute significantly to patient adherence across different ethnic/racial group. While many studies have talked about the use of patient portals helped in improving patient care, this study was first of its kind to demonstrate that patient portals have actually improved medication adherence. Whites improved adherence to medication by using an online refill function in patient portal

Counseling patients is extremely important; it allows pharmacists with the opportunity to better understand the health status of their patients. If a patient doesn’t know what, why or how to take their medication. We are the ones who help educate them. Better informed patients equates to better overall healthcare. If they are more medically literate before seeking our help, we can better assist them. As they begin to inquire more, it pushes health care providers to be more conscientious of their tasks. Greater care and consideration is taken when our patients can also hold us accountable. Encouraging patients to reach out with concerns or comments will benefit the pharmacist patient care process. For example, if the patient was able to identify that the drug name, though similar, were blatantly incorrect and brought it to the attention of her pharmacist they could have fixed it before the patient walked out the

Pew, Stephen, Ph.D (2008). Introduction to Health Services. 7th Ed. [Video] Thomson Delmar Learning. Retrieved from:

In all honesty I enjoyed the medical adherence project. It is not often in many of my college courses I get to participate in an hands on project. Participating in the medical adherence project I believe allows one to understand to some degree what one has to go through with a chronic illness. Taking the red pill and blue pill was fairly easy for me. I have struggled on and off with severe acne for around 9-10 years. Over that course of time I was on two different antibiotics for two years. Both that I was prescribed were to be taken in the morning and night. I as well over this course have had some type of facial regimen almost every day since I have struggled with acne. Though, it has taught me consistency and has ingrained in me regimens.

It may seem inevitable that high readmission rate is one of the challenges that an acute care setting is currently facing. According to studies, 20 percent of Medicare patients alone, get readmitted within 30 days of discharge. (Alper, E., O’Malley, T., & Grrenwald, J. 2017). Avoiding or preventing hospital readmission within 30 days of discharge can help Medicare save around $17 billion dollars yearly. (Morse, S. 2016). Understanding and getting to the root of why high re-admission rates still occur is highly important. Not only it will be cost effective but will also create a better well-being on the patients.