Pilot study to assess the influence of an enhanced medication plan on patient knowledge at hospital discharge

Send, Alexander Francesco Josef; Schwab, Michael; Gauss, Annika; Rudofsky, Gottfried; Haefeli, Walter E.; Seidling, Hanna M.

doi:10.1007/s00228-014-1723-9

Cited by 22 publications

(34 citation statements)

References 32 publications

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“…Implementation of an enhanced medication plan as an adjunct to the discharge conversation between physician and patient improved information transfer and patients’ knowledge of their drug treatment in a cohort of patients from several internal clinics in a university hospital. Interestingly, the intervention did not prolong the overall discharge process 21. Although, to date, a clear survival benefit of in-hospital or discharge education could not be demonstrated, prior data have suggested that discharge education may result in fewer days of hospitalization, lower costs, and lower mortality rates within a 6-month follow-up 24…”

Section: Discussionmentioning

confidence: 95%

“…Patients who receive structured in-hospital education have higher knowledge scores at discharge and 1 year later when compared with those who did not receive in-hospital education 20. Among the strategies to improve recall of medical advice, complementing verbal information with written instructions improved medication recall in a broad spectrum of patient populations 21–23. Implementation of an enhanced medication plan as an adjunct to the discharge conversation between physician and patient improved information transfer and patients’ knowledge of their drug treatment in a cohort of patients from several internal clinics in a university hospital.…”

Section: Discussionmentioning

confidence: 99%

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Medication knowledge of patients hospitalized for heart failure at admission and after discharge

Custodis¹,

Rohlehr²,

Wachter³

et al. 2016

PPA

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BackgroundA substantial aspect of health literacy is the knowledge of prescribed medication. In chronic heart failure, incomplete intake of prescribed drugs (medication non-adherence) is inversely associated with clinical prognosis. Therefore, we assessed medication knowledge in a cohort of patients with decompensated heart failure at hospital admission and after discharge in a prospective, cross-sectional study.MethodsOne hundred and eleven patients presenting at the emergency department with acute decompensated heart failure were included (mean age 78.4±9.2, 59% men) in the study. Patients’ medication knowledge was assessed during individual interviews at baseline, course of hospitalization, and 3 months after discharge. Individual responses were compared with the medical records of the referring general practitioner.ResultsMedian N-terminal prohormone of brain natriuretic peptide plasma concentration in the overall population at baseline was 4,208 pg/mL (2,023–7,101 pg/mL [interquartile range]), 20 patients died between the second and third interview. The number of prescribed drugs increased from 8±3 at baseline to 9±3 after 3 months. The majority of patients did not know the correct number of their drugs. Medication knowledge decreased continuously from baseline to the third interview. At baseline, 37% (n=41) of patients stated the correct number of drugs to be taken, whereas only 18% (n=16) knew the correct number 3 months after discharge (P=0.008). Knowledge was inversely related to N-terminal prohormone of brain natriuretic peptide levels.ConclusionMedication knowledge of patients with acute decompensated heart failure is poor. Despite care in a university hospital, patients’ individual medication knowledge decreased after discharge. The study reveals an urgent need for better strategies to improve and promote the knowledge of prescribed medication in these very high-risk patients.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Medication knowledge of patients hospitalized for heart failure at admission and after discharge

Custodis¹,

Rohlehr²,

Wachter³

et al. 2016

PPA

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“…The intervention measures were adapted to the requirements of doctors in private practice after optimized communication with the hospitals. We did not aim to study the effect of individual modules or to evaluate the benefit of medication checks; other studies have already done so (1,2). Studies that were conducted in non-German speaking countries have shown that multifactorial problems at interfaces can be solved quickly by combining several measures in medication management (3).…”

Section: In Replymentioning

confidence: 99%

“…The authors studied the two interfaces when a patient passes from one care sector into another with regard to their implications for medication, and they attempted to structure this (1). While the title implies a study of an intervention after discharge, what was actually studied were several interventions in an inpatient setting, whose respective proportion in the overall result is not easy to identify.…”

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confidence: 99%

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Bertsche¹,

Greißing²

2017

Deutsches Ärzteblatt International

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“…Patients should be educated and encouraged to become more engaged with their healthcare management, including asking any questions to understand the intended use of all medications. A recent study showed how reviewing enhanced medication plans with patients upon hospital discharge improved patient knowledge of their individual medication treatment without prolonging the overall process [17]. Although this study was conducted in the inpatient setting, it highlights how process improvements can improve the quality of care and patient satisfaction without requiring additional time.…”

Section: Improvement In Processes Of Carementioning

confidence: 99%

Warfarin and Rivaroxaban Duplication: A Case Report and Medication Error Analysis

Fusco

Paulus

Shubat

et al. 2015

Drug Saf - Case Rep

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A 62-year-old African American man received unintentional duplicate anticoagulation therapy with warfarin 5 mg and rivaroxaban 20 mg daily for the treatment of recurrent pulmonary embolism. The patient presented to the anticoagulation clinic 6 days after hospital discharge with an International Normalized Ratio (INR) of 2.3 and he was instructed to continue warfarin 5 mg daily. Seven days later, he returned to the clinic with an INR >8.0 using a point-of-care device. He denied any signs or symptoms of bleeding. During the interview, he reported starting a new medication for neuropathy 5 days earlier. The clinical pharmacist contacted the dispensing pharmacy and determined rivaroxaban 20 mg was the new medication. The patient denied receiving new prescription counseling at the dispensing pharmacy. Because rivaroxaban can falsely elevate INR results, the actual INR value was unknown. To minimize the risk for recurrent venous thromboembolism, vitamin K was not administered and no warfarin doses were held. Rather, the patient was instructed to stop rivaroxaban and reduce the warfarin dose. Five days later, the patient returned with an INR of 4.3. He still had not experienced any signs or symptoms of bleeding. The patient was quickly stabilized on a warfarin maintenance dose of 22.5 mg weekly. The anticoagulation clinic pharmacist notified management at the clinic and at the dispensing pharmacy in an effort to identify process errors and prevent additional incidents.

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Pilot study to assess the influence of an enhanced medication plan on patient knowledge at hospital discharge

Abstract: The provision of an EMP improves information transfer and therefore increases the patients' knowledge of their individual drug treatment without prolonging the overall discharge process.

Cited by 22 publications

References 32 publications

Medication knowledge of patients hospitalized for heart failure at admission and after discharge

Medication knowledge of patients hospitalized for heart failure at admission and after discharge

In Reply

Warfarin and Rivaroxaban Duplication: A Case Report and Medication Error Analysis

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