Hospital Based Medication Delivery

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Identifier 2017_Duffey
Title Hospital Based Medication Delivery
Creator Duffey, Chantel
Subject Advanced Practice Nursing; Education, Nursing, Graduate; Medication Adherence; Pharmacy Service, Hospital; Patient Readmission; Self Care; Patient Discharge; Patient Education as Topic; Health Literacy; Centers for Medicare and Medicaid Services (U.S.); Quality Improvement
Description Hospital readmission is a costly and common occurrence in the United States. Research suggests that a portion of all hospital readmissions can be attributed to medication non-adherence after discharge. One strategy for improving adherence to prescribed medications is to ensure patients obtain medications as prescribed before they leave the hospital. A program called Med-READI was developed at a large teaching hospital in the Salt Lake Valley to remove barriers in obtaining medications and improve post-discharge medication adherence. The utilization and effectiveness of this program had not been well-evaluated, specifically in regards to those who opted to not use the program (non-utilizers). The specific objectives of this scholarly project were as follows (1) identify differences between patients who both chose and chose not to utilize a hospital based medication delivery program; (2) determine if commonalities exist for not utilizing the program; (3) determine medication adherence rates for program non-utilizers; and (4) disseminate findings to key stakeholders in pharmacy services. A thorough literature review demonstrated the complexity and multivariate nature of hospital readmission. Many barriers prevent or deter patients from obtaining their prescribed medications; however, by focusing on medication adherence, this project addressed one factor known to contribute to hospital readmission. This project sought to analyze utilization trends of a pre-discharge medication delivery program to address quality improvement opportunities. To further evaluate the effectiveness of this program this project analyzed whether non-utilizers had filled their discharge medications within twenty-four hours post-discharge. In order to determine utilization trends, data were collected and analyzed over two weeks. Those who utilized the Med-READI program were compared to those who did not utilize the Med-READI program in terms of gender, age, insurance coverage, and rural or urban home location. Insurance-based differences were notable when this trend analysis was performed. Patients' reasons for opting out of the Med-READI program were also compiled, and a hierarchy of reasons why the program was not utilized was developed. Lastly, the medication adherence rates of non-utilizers were determined by a phone survey of patients who opted out of the program and assessed for post-discharge medication obtainment. The results of this survey indicated a high rate of non-adherence for those who opted out. This information was then presented to stakeholders in pharmacy services to allow for quality improvement of the Med-READI program and to better understand its effectiveness. This information was also disseminated through a poster presentation at the University of Utah College of Nursing Medication adherence is a known contributor to hospital readmission. Programs have been developed to alleviate the concern for poor medication adherence post-discharge. The proposed project allowed for a better understanding of the utilization and effectiveness of one such program called Med-READI. Quality improvement of the Med-READI program will allow for increased patient participation and potential reduction in hospital readmission.
Relation is Part of Graduate Nursing Project, Doctor of Nursing Practice, DNP
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2017
Type Text
Rights
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Language eng
ARK ark:/87278/s6x104hm
Setname ehsl_gradnu
ID 1279399
Reference URL https://collections.lib.utah.edu/ark:/87278/s6x104hm
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