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:10/13/2017)... , ... October 13, 2017 , ... Ellevate Network, the ... business to advocate for action towards gender equality at their inaugural Summit in New ... the globe, and reached a social audience of over 3 million. To watch the ...
(Date:10/13/2017)... ... October 13, 2017 , ... Talented host, ... lowdown on sciatica in a new episode of "Success Files," which is an ... and innovation and investigates each subject in-depth with passion and integrity. , Sciatica ...
(Date:10/13/2017)... , ... October 13, 2017 , ... “America On The ... identity. “America On The Brink” is the creation of published author, William Nowers. ... great-grandchildren. As a WWII veteran, he spent thirty years in the Navy. ...
(Date:10/12/2017)... ... ... Planet Fitness, one of the largest and fastest growing franchisors and operators ... location in Covington, LA at 401 N. U.S. Highway 190, in January of 2018. ... in the Holiday Square shopping center. Its location allows it to serve both Covington ...
(Date:10/12/2017)... ... 2017 , ... The American College of Medical Informatics (ACMI) will present the ... Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s Annual Symposium ... a pioneer in the field of medical informatics, this prestigious award is presented to ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... 2, 2017  AllianceRx Walgreens Prime, the combined central ... and pharmacy benefit manager Prime Therapeutics LLC (Prime), today ... included the unveiling of new signage at its headquarters ... as at a few other company-owned facilities across the ... patients, some of whom will begin to see the ...
(Date:9/28/2017)... Hill-Rom Holdings, Inc. (NYSE: HRC), will host ... webcast on Friday, November 3, 2017, beginning at 7:00 ... approximately 8:30 a.m. (CDT) / 9:30 a.m. (EDT). ... performance and guidance for 2018, Hill-Rom executives will also ... performance, and long-range financial outlook through 2020. ...
(Date:9/27/2017)... , Sept. 27, 2017  DarioHealth Corp. (NASDAQ: DRIO), a leading global ... that its MyDario product is expected to appear on The Dr. Oz ... Dr. Oz Show airs in your area: http://www.doctoroz.com/page/where-watch-dr-oz-show ... The nine-time Emmy award-winning, The Dr. Oz Show kicked ... The segment features ...
Breaking Medicine Technology: