Navigation Links
Staying on medication may not translate to avoiding readmission
Date:11/18/2013

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 typically responded. Many of the patients said they quit taking their medications when symptoms persisted, believing the drugs were ineffective. They also reported that they primarily headed to the hospital emergency department when symptoms escalated, often leading to higher admission rates.

With coaching from the nurses at three, six and 12 months, patients in the intervention were tutored about managing their symptoms, taking their pills on schedule, and developing an action plan for addressing their symptoms. They were encouraged to use doctors' offices and clinics rather than the emergency department.

The approach was successful, Granger reported. Patients who received the intervention were four times as likely to adhere to their medication regimens as the comparison group.

"We were able to dramatically improve medication compliance, and that was the primary end-point of the study," Granger said.

But when the researchers looked at the hospital readmission rate, they found that readmissions were not significantly different between the two groups.

"We were surprised by this, and it's leading us to dig into what is going on," Granger said. "Our next area of study will focus on the complex factors that affect the patient experience and lead to the avoidable use of emergency health care resources. We thought it was medication adherence in large part, but it might be that many of the same social and economic factors causing health disparities may also contribute significantly to high resource use."


'/>"/>

Contact: Sarah Avery
sarah.avery@duke.edu
919-660-1306
Duke University Medical Center
Source:Eurekalert

Related medicine news :

1. Staying Home With Sick Kids Causes Job Worries for Parents: Survey
2. New Blog Post from iHealthology.com Announces Why Staying Fit Means Getting on the Move
3. Middleman Productions Announces that Provocative "Staying Grounded" Exhibit Finds Its Wings in Locations Around Massachusetts
4. Forgoing Medication, for Babys Sake
5. Parents poor math skills may lead to medication errors
6. Reducing off-label use of antipsychotic medications may save money
7. Common acne medication doubles risk of eye infection
8. Misuse of over-the-counter pain medication is potential health threat
9. Genes predict if medication can help you quit smoking
10. Acne Medication May Raise Risk of Eye Infections
11. New delivery method improves efficacy of 2 common Parkinsons disease medications
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2016)... (PRWEB) , ... May 26, 2016 , ... W.S. ... products, has been honored with a 2016 When Work Works Award for its use ... part of the national When Work Works project administered by the Families and Work ...
(Date:5/26/2016)... ... , ... On Memorial Day, Hope For Heroes and USA Medical ... for the country. The nonprofit Hope For Heroes partnered with the leading provider ... for disabled military veterans, as well as police, firemen, and EMS professionals across the ...
(Date:5/26/2016)... ... May 26, 2016 , ... Catalent ... for drugs, biologics, consumer health and global clinical supply services, today announced two ... support the company’s continued investment and strategic growth plans in the Asia Pacific ...
(Date:5/26/2016)... Indianapolis, Indiana (PRWEB) , ... May 26, 2016 ... ... national provider of healthcare supply chain solutions, today announced the organization has earned ... management meets international standards and is compliant with all rules and policies associated ...
(Date:5/26/2016)... NY (PRWEB) , ... May 26, 2016 , ... ... founder of Mehling Orthopedics and chief medical officer of Blue Horizon International (BHI), ... and Regeneration. The conference was held during May 5-6, 2016 in Chicago, IL, ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... May 25, 2016 As illustrated ... earlier this month, the numbers and momentum of cannabis ... climb into the billions, more research and development push ... Edition State of Legal Marijuana Markets Report  from from ... firm, much of the increase in sector is attributed ...
(Date:5/25/2016)... , May 25, 2016 MedDay, ... disorders, announces that an oral presentation entitled "High doses of ... MS-SPI trial" will be given by Professor Ayman Tourbah ... 2nd Congress of the European Academy of Neurology (EAN) in ... and related disorders 3" will take place on Sunday, 29 ...
(Date:5/24/2016)... -- Niederländische Chirurgen haben eine innovative ... erlaubt, ihre Expertise weltweit zu teilen und so ... mit einer Instant-Messaging-Funktion und der Möglichkeit, in einem ... Afrika, Asien und den USA ... Information und Weiterbildung   "MDLinking ...
Breaking Medicine Technology: