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Helping Patients Stay on Meds after Leaving Hospital

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A recent VA study revealed that heart patients are much more likely to take their medications if they receive personalized attention from their caregivers, such as a reminder call, after leaving the hospital.

by Tom Cramer, VA Staff Writer
Thursday, March 6, 2014

Did you know that up to 50 percent of heart patients fail to take their medications correctly after they leave the hospital?

It’s a disturbing number, but VA may have found a potential solution to the problem.

“The fact is, when your pharmacist calls you and reminds you to take your meds, you’re more likely to take your meds,” said Dr. Michael Ho, a researcher at the Denver VA Medical Center.

The Bottom Line

Ho’s recent study on the topic incorporated several interventions, including patient education, collaboration between pharmacists and primary care providers, medication reconciliation, and automated telephone reminder calls.

“The bottom line is this: you need to continue to engage your patients in their care once they leave the hospital,” the researcher said. “This includes calling them at home and reminding them to take their pills…”

Ho, whose study on this topic appears in the November 18, 2013 issue of JAMA Internal Medicine, said the health care system in the United States, in general, is really not set up to provide this kind of individual attention to patients once they leave the hospital.

His year-long study involved 241 patients from four VA medical centers across the United States. Researchers randomly assigned patients to receive typical care or more personalized care.

The investigation revealed that nearly 75 percent of patients who received typical care followed their treatment plan, compared to almost 90 percent of those who received individualized attention.

We discovered, through patient interviews, that some people are downright scared of their medication.

The Only Thing We Have to Fear is Fear Itself

“There are probably many reasons people don’t take their meds properly,” Ho said. “Some people don’t like the side effects of their medication, so they ‘forget’ to take it. Others just really forget. Others have multiple pills to take, at different times during the day, so they get confused.

“Still others,” he continued, “are just plain frightened. We discovered, through patient interviews, that some people are downright scared of their medication. Fear seemed to be a common theme.”

So how, exactly, did Ho and his team encourage their study participants to take their meds?

“We did two types of reminder calls,” the researcher explained. “We’d give them an ‘educational’ call once a month to explain why it’s so important to take your heart medication. Then we’d give them your basic ‘Don’t Forget to Take Your Meds’ reminder call.

“We’d call them 14 days before their prescription expired. Then we’d call them seven days before their prescription expired.

Is Everything OK?

“After all that, if they still didn’t refill it, their pharmacist would call them on the very day their prescription was due to expire,” Ho said. “Their pharmacist would simply ask them if everything was OK, and if they had any questions about their meds.”

The researcher said the heart patients in his study were also given the direct number of their VA pharmacist, which meant they didn’t have to first call the main VA number.

“This way they could reach their pharmacist a lot easier if they had any questions or concerns,” he observed. “We gave them direct access to the person they needed to talk to.”