Medication management remains challenging for providers as patients continue to be readmitted for non-compliance with medication. With readmission penalties looming and the gradual shift to value-based models of care, programs must rethink how they can help modify patient behavior outside the hospital setting.
New technologies offer some promise in resolving adherence issues, leveraging reminders and behavioral modification to boost compliance. However many of these solutions have seen limited provider adoption aiming to address the growing readmissions problem.
Greater investment potential in medication management
Medication adherence is a complex issue, and is attributable to nearly two thirds of readmissions, according to some studies. However, a recent study published in the Journal of the American College of Cardiology examining hospital efforts to reduce readmissions reveals that few programs emphasize medication management.
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Most programs reported that all patients received discharge instructions with names, dose, and frequency of discharge medications, and that many leverage teach-back techniques. However, 14% of hospitals sometimes failed to assign responsibility for medication reconciliation, and only 3.2% always made contact with an outside pharmacy.
Inpatient and outpatient prescription records were electronically linked in 28.9% of hospitals. The discharge summary was sent directly to the patient’s primary medical doctor in only 25.5% of hospitals.
While managing medication post discharge is important to readmission reduction efforts, few programs have isolated a complete fix. The solution may be multifaceted, and new technologies could offer substantial opportunity to improve outcomes by allowing the hospital to gain a greater ability to manage patient behavior after discharge
Patient portals provide better access to information
Granting patient access to electronic health information is one way to encourage patient compliance. While evidence varies regarding the effectiveness of these platforms, the more successful solutions focus on specific patient needs.
Roundtable research has uncovered some key elements to drive patient portal success, including:
- Web-based access, allowing patients to view information from home
- Lists of current medications and associated medication-specific information
- Ability to share medication information with relevant providers
- Ability to request refills, schedule physician appointments, communicate with care team
- Risk-modification behavior coaching (i.e., effects of exercise on heart health)
- Access to lab results and diagnostics to share with providers
Cellular-based reminders promote adherence
A second promising technology to enhance compliance with medications is cell phone-based alerts. This technology shows substantial effectiveness in encouraging patients to take medications.
A 2010 study examined the effectiveness of text-based reminders for patients with hypertension. Patients were reminded to take medications and make lifestyle modifications. Researchers noted a 43% point increase in medication adherence (from 50% to 93% adherence) after administering these alerts.
A number of vendors have entered this space, offering text-based solutions often paired with Bluetooth-enabled devices for vital sign monitoring. Many involve the purchase of a new platform, but not every solution requires investment.
For instance, Txt4health is a free, interactive, 14-week text messaging program for diabetic patients. A patient starts by texting HEALTH to a specific number. The first part of the program is a series of questions to determine the patient’s risk of developing type 2 diabetes—height, weight, diet, and other risk factors. With this information, an analytics engine tailors text messages to individual patients.
Similarly, the CardioSmart Med Reminder is another free program, but instead of text messages, it leverages an actual app. The program allows patients to keep track of medications, set customized alerts, and even share medication lists with providers.
Advanced medication storage devices hardwire behavioral change
Text reminders offer substantial potential to improve patient medication adherence. However, most providers know that patients can easily dismiss these warnings. To gain additional control over patients’ medication compliance, hospitals may turn to more advanced technologies.
One such technology is the PillStation, developed by SentiCare. It’s designed to hardwire patient compliance through a combination of monitoring and follow-up. The solution leverages two key components, an intelligent pill container and a personal care advisor.
Transparent pill containers are scanned every time the lid is closed, confirming that the right medications have been placed in the right containers, and that the right medications are being taken at appropriate times.
If a patient takes the wrong medicine, forgets to take their medicine, or otherwise fails to meet their guidelines, a care advisor is alerted and will reach out to the patient, their pharmacist, and their primary care physician to help correct the issue.
Source:The Advisory Board Company