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|
Duke University Medical Center