DURHAM, N.C. A targeted effort to help high-risk heart failure patients stay on their medications did improve adherence to drug regimens, but had surprisingly little effect lowering hospital readmission rates, according to a study at Duke Medicine.
The findings, presented Monday at the American Heart Association's Scientific Sessions meeting in Dallas, suggest that medication management is just one of many issues facing patients most at risk for their conditions to worsen.
"We found that we could solve much of the problem around medication adherence, but that is not the whole issue," said Bradi B. Granger, RN, Ph.D., director of the Heart Center Nursing Research Program at Duke. "This illuminates the opportunities we have to help patients in a much broader way, redesigning care to confront some of the issues that keep the most vulnerable patients from regaining their health."
Increasingly, hospitals face financial penalties from the Medicare and Medicaid insurance programs if patients are readmitted within 30 days. To reduce readmissions, hospitals are working to coordinate better and more intensive follow-up care in outpatient settings. Making sure patients take their medications has been a key component.
Granger and colleagues reported the findings from a study at Duke called CHIME, for Chronic Heart Failure Intervention to Improve Medication Adherence. The study was designed to learn why patients skip their medications, and test whether a nursing intervention could improve compliance.
Granger said 86 heart failure patients at high risk for poor medication adherence were randomly assigned to one of two groups: those who were periodically contacted and coached by nurses about taking their medications, and those who were contacted on the same schedule but did not receive the coaching.
As part of the intervention, nurses asked the patients about their symptoms, what triggered their symptoms and how they t
|Contact: Sarah Avery|
Duke University Medical Center