2.50
Hdl Handle:
http://hdl.handle.net/10755/211568
Type:
Research Study
Title:
REDUCING ACUTE CARE USE BY RESOLVING MEDICATION DISCREPANCIES
Abstract:
Purpose:  To evaluate the impact of a transitional care medication discrepancy intervention on urgent and acute care service use within 30 days following an index hospital discharge. Rationale/Conceptual Basis:  Nationwide nearly 20% of patients with Medicare are readmitted to the hospital within 30 days after an initial hospitalization, costing over $17 billion annually. Approximately 75% of these readmissions are believed to be preventable. Medication discrepancies have a known impact on adverse drug events that lead to  preventable emergency department (ED) visits and hospital readmissions. The Economic, Clinical, and Humanistic Outcomes Model guided this study to evaluate the impact of a transitional care medication discrepancy intervention on subsequent urgent and acute care use and charges. Methods: An IRB-approved randomized clinical trial (N = 232) was completed. In this single-blind study, two home health nurses received specific training related to identifying and resolving medication discrepancies. Participants randomized to the intervention group (n = 117) were admitted and case managed by one of the two nurse interventionists. Total time required for the intrvention ranged from 15-30 minutes per participant. Control group participants (n = 115) received usual care from other home health nurses blinded to patients’ participation in the study. The investigator that conducted the utilization analyses was blinded to group assignment. Results: Intervention group participants had a total of 12 ED visits and hospitalizations within the 30 days following their index hospital discharge whereas control group participants had 33 ED visits and hospitalizations within 30 days following their index hospital discharge (p = 0.002). Total acute care charges were $430,261.66 for controls within the first 30 days of discharge and $221,611.50 for intervention group; a 48.5% reduction in hospital charges. Analyses to determine the number needed to treat (NNT) revealed that only 5.4 patients would need to receive the discrepancy identification and resolution intervention to prevent an acute care encounter within 30 days following hospital discharge. Implications: An intervention to consistently identify and resolve medication discrepancies following hospital discharge appears to be an effective way of reducing acute care use and charges among patients receiving home health care. Disseminating this intervention to home care providers and testing it in other populations is recommended.
Keywords:
Acute care use; Medication discrepancies
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5496
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleREDUCING ACUTE CARE USE BY RESOLVING MEDICATION DISCREPANCIESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211568-
dc.description.abstractPurpose:  To evaluate the impact of a transitional care medication discrepancy intervention on urgent and acute care service use within 30 days following an index hospital discharge. Rationale/Conceptual Basis:  Nationwide nearly 20% of patients with Medicare are readmitted to the hospital within 30 days after an initial hospitalization, costing over $17 billion annually. Approximately 75% of these readmissions are believed to be preventable. Medication discrepancies have a known impact on adverse drug events that lead to  preventable emergency department (ED) visits and hospital readmissions. The Economic, Clinical, and Humanistic Outcomes Model guided this study to evaluate the impact of a transitional care medication discrepancy intervention on subsequent urgent and acute care use and charges. Methods: An IRB-approved randomized clinical trial (N = 232) was completed. In this single-blind study, two home health nurses received specific training related to identifying and resolving medication discrepancies. Participants randomized to the intervention group (n = 117) were admitted and case managed by one of the two nurse interventionists. Total time required for the intrvention ranged from 15-30 minutes per participant. Control group participants (n = 115) received usual care from other home health nurses blinded to patients’ participation in the study. The investigator that conducted the utilization analyses was blinded to group assignment. Results: Intervention group participants had a total of 12 ED visits and hospitalizations within the 30 days following their index hospital discharge whereas control group participants had 33 ED visits and hospitalizations within 30 days following their index hospital discharge (p = 0.002). Total acute care charges were $430,261.66 for controls within the first 30 days of discharge and $221,611.50 for intervention group; a 48.5% reduction in hospital charges. Analyses to determine the number needed to treat (NNT) revealed that only 5.4 patients would need to receive the discrepancy identification and resolution intervention to prevent an acute care encounter within 30 days following hospital discharge. Implications: An intervention to consistently identify and resolve medication discrepancies following hospital discharge appears to be an effective way of reducing acute care use and charges among patients receiving home health care. Disseminating this intervention to home care providers and testing it in other populations is recommended.en_GB
dc.subjectAcute care useen_GB
dc.subjectMedication discrepanciesen_GB
dc.date.available2012-02-20T12:02:47Z-
dc.date.issued2012-02-20T12:02:47Z-
dc.date.accessioned2012-02-20T12:02:47Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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