High-risk heart failure patients receiving nursing intervention were four times as likely to take their medication, but their hospital readmission rates were not impacted, according to a study at Duke Medicine.
To find out why patients skip their medications, and if nursing intervention could improve compliance, researchers randomly assigned 86 heart failure patients at high risk for poor medication adherence 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, called CHIME, for Chronic Heart Failure Intervention to Improve Medication Adherence, 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 (ED) 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.
Patients who received the intervention were four times as likely to adhere to their medication regimens as the comparison group.
But when the researchers looked at the hospital readmission rate, they found that readmissions were not significantly different between the two groups.
Medication management is just one of many issues facing patients most at risk for their conditions to worsen, researchers found, and redesigning care to confront the issues that are keeping the vulnerable from regaining their health has to be addressed.
Source: Duke Medicine , November 18, 2013
2013 Healthcare Benchmarks: Improving Medication Adherence provides actionable information from more than 100 healthcare organizations on efforts to improve medication adherence and compliance in their populations. Now in its third year, this annual analysis documents the impact of these programs on adherence and compliance levels, medication costs, ER visits, hospital and skilled nursing facility admissions, risk of death, and other areas of concern.