A study recently published in Mayo Clinic Proceedings confirms that medication discrepancies continue to be a dangerous problem for older patients discharged from the hospital.¹ Amanda Mixon, MD and colleagues followed 471 patients (mean age 59 years) hospitalized for acute coronary symptoms and/or acute decompensated heart failure. In post-discharge interviews, patients were asked to report the medications they were taking. More than half (51.4%) either reported a medication that was not on their list or failed to take a medication that was on their list. On average, those who had such discrepancies had two discordant medications. Additionally, 59.2% of these patients demonstrated a misunderstanding in indication, dose, or frequency of a cardiac medication. These results are consistent with older studies finding 30% to 70% medication errors among patients discharged from the hospital with various diseases - not just cardiovascular.²⁻⁶ Inasmuch as Dr. Mixon et al. used telephone follow-up, it is possible that the medication discrepancies are understated in the current study. A previous study found that when in-home nursing visits followed telephone follow-up, the in-home nursing visits detected additional medication discrepancies that were not detected in the telephone follow-up.⁷
These studies suggest that many patients, especially patients with polypharmacy, cannot reliably adhere to their medication regimen after only one session of training. Non-adherence is not limited to patients discharged from the hospital. A recent study following 195,930 e-prescriptions found that 22% of the prescriptions were not even filled.⁸
Doctors and discharge planners can use Five Star Home Health as one solution to this patient safety and care-effectiveness dilemma. Whenever a doctor prescribes a new medication, the doctor's assessment of a need for more education satisfies Medicare's skilled need requirement to justify a home health episode. Various studies have shown nurse follow-up to improve patient adherence to prescribed diets and medications.⁹⁻¹⁸ Five Star Home Health is positioned well to be your partner for improving patient adherence. Making multiple visits to the homes of your patients over the course of weeks or months, our nurses can reinforce your teaching, follow up to ensure adherence, identify barriers to adherence, and implement a variety of plans to overcome those barriers. Five Star Home Health nurses will address understanding and motivation, transportation barriers, and solutions to forgetfulness. With access to the home environment, our nurses can recruit and train family members for assistance and use the home environment to set up better, personalized reminder systems.
A Particularly Qualified Nursing Team
When you refer to Five Star Home Health, you give your patients access to an unusually qualified nursing team with many years of experience each and a passion for caring. Our nursing team credentials include: