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Medication reconciliation medication adherance

Satya Surbhi, Kiraat D Munshi, Paula C Bell, James E Bailey
OBJECTIVES: First, to investigate the prevalence and types of drug therapy problems and medication discrepancies among super-utilizers, and associated patient characteristics. Second, to examine the outcomes of pharmacist recommendations and estimated cost avoidance through care transitions support focused on medication management. DESIGN: Retrospective analysis of the pharmacist-led interventions as part of the SafeMed Program. SETTING: A large nonprofit health care system serving the major medically underserved areas in Memphis, Tennessee...
October 6, 2016: Journal of the American Pharmacists Association: JAPhA
Kelly L Hayward, Patricia C Valery, W Neil Cottrell, Katharine M Irvine, Leigh U Horsfall, Caroline J Tallis, Veronique S Chachay, Brittany J Ruffin, Jennifer H Martin, Elizabeth E Powell
BACKGROUND: Cirrhosis patients are prescribed multiple medications for their liver disease and comorbidities. Discrepancies between medicines consumed by patients and those documented in the medical record may contribute to patient harm and impair disease management. The aim of the present study was to assess the magnitude and types of discrepancies among patient-reported and medical record-documented medications in patients with cirrhosis, and examine factors associated with such discrepancies...
2016: BMC Gastroenterology
Babar Bashir, Doron Schneider, Mary C Naglak, Thomas M Churilla, Marguerite Adelsberger
OBJECTIVES: Factors that influence the likelihood of readmission for chronic obstructive pulmonary disease (COPD) patients and the impact of posthospital care coordination remain uncertain. LACE index (L = length of stay, A = Acuity of admission; C = Charlson comorbidity index; E = No. of emergency department (ED) visits in last 6 months) is a validated tool for predicting 30-days readmissions for general medicine patients. We aimed to identify variables predictive of COPD readmissions including LACE index and determine the impact of a novel care management process on 30-day all-cause readmission rate...
August 2016: Hospital Practice (Minneapolis)
Jennifer M Polinski, Janice M Moore, Pavlo Kyrychenko, Michael Gagnon, Olga S Matlin, Joshua W Fredell, Troyen A Brennan, William H Shrank
Adverse drug events and the challenges of clarifying and adhering to complex medication regimens are central drivers of hospital readmissions. Medication reconciliation programs can reduce the incidence of adverse drug events after discharge, but evidence regarding the impact of medication reconciliation on readmission rates and health care costs is less clear. We studied an insurer-initiated care transition program based on medication reconciliation delivered by pharmacists via home visits and telephone and explored its effects on high-risk patients...
July 1, 2016: Health Affairs
Sophie Marien, Bruno Krug, Anne Spinewine
OBJECTIVES: Medication reconciliation (MedRec) is essential for reducing patient harm caused by medication discrepancies across care transitions. Electronic support has been described as a promising approach to moving MedRec forward. We systematically reviewed the evidence about electronic tools that support MedRec, by (a) identifying tools; (b) summarizing their characteristics with regard to context, tool, implementation, and evaluation; and (c) summarizing key messages for successful development and implementation...
June 14, 2016: Journal of the American Medical Informatics Association: JAMIA
Leo Buckley, Stephanie Labonville, Judith Barr
PURPOSE OF REVIEW: The prevalence of hypertension and uncontrolled hypertension is higher among African Americans than any other ethnicity in the USA. Certain patient medical beliefs may lead to adverse health behaviors. The aim of this study was to systematically review and narratively synthesize beliefs about hypertension among African Americans. RECENT FINDINGS: In a narrative review of 22 studies, many participants attributed hypertension to stress and fatty foods...
July 2016: Current Hypertension Reports
Kristina M Niehoff, Nallakkandi Rajeevan, Peter A Charpentier, Perry L Miller, Mary K Goldstein, Terri R Fried
STUDY OBJECTIVE: To create a clinical decision support system (CDSS) for evaluating problems with medications among older outpatients based on a broad set of criteria. DESIGN: Web-based CDSS development. SETTING: Primary care clinics at a Veterans Affairs medical center. PARTICIPANTS: Forty veterans 65 years and older who were prescribed seven or more medications that included those for treatment of diabetes mellitus and hypertension...
June 2016: Pharmacotherapy
Haleigh James, Paul Lorentz, Maria L Collazo-Clavell
BACKGROUND: Roux-en-Y gastric bypass (RYGB) is associated with nutrient deficiencies, but the optimal supplement regimen remains unclear. We assessed patient-reported adherence to and efficacy of Mayo Clinic's post-RYGB vitamin/mineral supplement protocol and the related incidence of common nutrient deficiencies. METHODS: Data were collected on 287 obese patients who underwent RYGB. Patient-reported supplement adherence was assessed via medication/supplement lists generated by medication reconciliation in hospital dismissal summaries and clinic notes at 6, 12, and 18-36 months postsurgery...
April 1, 2016: Obesity Surgery
Robert Schoenhaus, Adam Lustig, Silvia Rivas, Victor Monrreal, Kimberly D Westrich, Robert W Dubois
BACKGROUND: Even within fully integrated health care systems, primary care providers (PCPs) often lack support for medication management. Because challenges with conducting medication reconciliation, improving adherence, and achieving optimal patient outcomes continue to be prevalent nationally, it is critical that PCPs are provided the resources and support they need to provide high-quality, patient-centered care in an accountable care environment. PROGRAM DESCRIPTION: Sharp Rees-Stealy Medical Group uses a fully electronic medication refill system that allows for a centralized team to manage all incoming requests...
March 2016: Journal of Managed Care & Specialty Pharmacy
Patrick Redmond, Hailey Carroll, Tamasine Grimes, Rose Galvin, Ronan McDonnell, Fiona Boland, Ronald McDowell, Carmel Hughes, Tom Fahey
OBJECTIVE: The aim of this study was to survey GPs and community pharmacists (CPs) in Ireland regarding current practices of medication management, specifically medication reconciliation, communication between health care providers and medication errors as patients transition in care. METHODS: A national cross-sectional survey was distributed electronically to 2364 GPs, 311 GP Registrars and 2382 CPs. Multivariable associations comparing GPs to CPs were generated and content analysis of free text responses was undertaken...
April 2016: Family Practice
Susan P Bell, Jeffrey L Schnipper, Kathryn Goggins, Aihua Bian, Ayumi Shintani, Christianne L Roumie, Anuj K Dalal, Terry A Jacobson, Kimberly J Rask, Viola Vaccarino, Tejal K Gandhi, Stephanie A Labonville, Daniel Johnson, Erin B Neal, Sunil Kripalani
BACKGROUND: Reduction in 30-day readmission rates following hospitalization for acute coronary syndrome (ACS) and acute decompensated heart failure (ADHF) is a national goal. OBJECTIVE: The aim of this study was to determine the effect of a tailored, pharmacist-delivered, health literacy intervention on unplanned health care utilization, including hospital readmission or emergency room (ER) visit, following discharge. DESIGN: Randomized, controlled trial with concealed allocation and blinded outcome assessors SETTING: Two tertiary care academic medical centers PARTICIPANTS: Adults hospitalized with a diagnosis of ACS and/or ADHF...
May 2016: Journal of General Internal Medicine
Thomas S Bacon, Kenneth C Fan, Manishi A Desai
PURPOSE: To evaluate consistency in documentation of glaucoma medications in the electronic medical record and identify which regimen patients adhere to when inconsistencies exist. Factors contributing to medication nonadherence are also explored. METHODS: Retrospective chart review of medication adherence encompassing 200 patients from three glaucoma physicians at a tertiary referral center over a 1-month period. Adherence was determined by the consistency between a patients stated medication regimen and either the active medication list in the electronic medical record, or the physicians planned medication regimen in the preceding clinic visit...
2016: Clinical Ophthalmology
Kelly D Karpa, Lindsay L Hom, Paul Huffman, Erik B Lehman, Vernon M Chinchilli, Paul Haidet, Shou Ling Leong
BACKGROUND: Adverse drug reactions are a leading cause of death in the United States. Safe and effective management of complex medication regimens is a skill for which recent medical school graduates may be unprepared when they transition to residency. We wished to assess the impact of a medication safety curriculum on student competency when evaluating medication therapeutic appropriateness as well as evaluate students' ability to transfer curricular material to management of patients in clinical settings...
2015: BMC Medical Education
Tantri Budiman, Kimberly Snodgrass, Allison Komatsu Chang
BACKGROUND: Hospital readmissions have been shown to contribute to both patient morbidity and rising health care expenditures across a number of disease processes. Adherence to a cardioprotective drug regimen is particularly important after ST-segment elevated myocardial infarction (STEMI) because it is an acute condition associated with high patient morbidity and mortality. OBJECTIVE: The objective of this study was to evaluate the effectiveness of pharmacist intervention with regard to reduction in hospital readmissions and improvement in medication adherence and literacy...
February 2016: Annals of Pharmacotherapy
Gerda Längst, Hanna Marita Seidling, Marion Stützle, Dominik Ose, Ines Baudendistel, Joachim Szecsenyi, Michel Wensing, Cornelia Mahler
PURPOSE: This qualitative study in patients with type 2 diabetes and health care professionals (HCPs) aimed to investigate which factors they perceive to enhance or impede medication information provision in primary care. Similarities and differences in perspectives were explored. METHODS: Eight semistructured focus groups were conducted, four with type 2 diabetes patients (n=25) and four with both general practitioners (n=13) and health care assistants (n=10). Sessions were audio and video recorded, transcribed verbatim, and subjected to computer-aided qualitative content analysis...
2015: Patient Preference and Adherence
Géraldine Leguelinel-Blache, Florent Dubois, Sophie Bouvet, Clarisse Roux-Marson, Fabrice Arnaud, Christel Castelli, Valérie Ray, Jean-Marie Kinowski, Albert Sotto
Quality of transitions of care is one of the first concerns in patient safety. Redesigning the discharge process to incorporate clinical pharmacy activities could reduce the incidence of postdischarge adverse events by improving medication adherence. The present study investigated the value of pharmacist counseling sessions on primary medication adherence after hospital discharge.This study was conducted in a 1844-bed hospital in France. It was divided in an observational period and an interventional period of 3 months each...
October 2015: Medicine (Baltimore)
Lauren Balling, Brian L Erstad, Kurt Weibel
OBJECTIVE: To assess the impact of a transition-of-care pharmacist during hospital discharge. SETTING: An academic medical center in southern Arizona. PRACTICE DESCRIPTION: One pharmacist coordinated patient discharges in two inpatient units from August 2012 through July 2013. The pharmacist attended interdisciplinary discharge coordination meetings, ensured appropriate discharge orders, facilitated the filling of medications, and educated patients on discharge medications...
July 2015: Journal of the American Pharmacists Association: JAPhA
Tom Kalista, Virginia Lemay, Lisa Cohen
OBJECTIVE: To establish a community pharmacist-provided home health service to improve medication adherence and reduce 30-day heart failure-related hospital readmissions. SETTING: Visiting Nurse Services of Newport and Bristol Counties located in Portsmouth, RI, from December 2013 to April 2014. PRACTICE DESCRIPTION: Each patient received one in-home visit provided by a Postgraduate Year 1 community pharmacy resident within 1 week of admission to visiting nurse services followed by two follow-up telephone calls, 1 week and 4 weeks after the visit...
July 2015: Journal of the American Pharmacists Association: JAPhA
Beate H Garcia, Trude Giverhaug, June U Høgli, Frode Skjold, Lars Småbrekke
OBJECTIVES: The aim of the study was twofold; 1) to develop a clinical pharmacist-led 12 month lasting follow-up program for patients with established coronary heart disease (CHD) discharged from the University Hospital of North Norway, and 2) to explore the impact of the program with regards to adherence to a medication assessment tool for secondary prevention of CHD and change in biomedical risk factors. METHODS: A total of 102 patients aged 18-82 years were enrolled in a non-blinded randomized controlled trial with an intervention group and a control group...
April 2015: Pharmacy Practice
Matthew E Arnold, Lucinda Buys, Fekadu Fullas
OBJECTIVE: The Medicare Hospital Readmissions Reduction Program (MHRRP) which took effect on October 1st, 2012 holds providers accountable for quality of care delivered, placing a greater focus on care coordination. Innovative strategies in medication management in the acute care and outpatient primary care settings require vigilant pharmacist intervention. The objective of this study is to determine if pharmacist-provided medication reconciliation service in conjunction with hospital follow-up outpatient physician visits reduces hospital readmission rate...
June 1, 2015: American Journal of Health-system Pharmacy: AJHP
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