For whatever reasons, some patients don't pick up their medication, while others aren't good about taking it. Walgreens and one Georgia hospital are writing a prescription to cure this pesky problem.
Since July 2011, they've been integrating pharmacists into patient care transition teams. By delivering prescriptions to the bedside before discharge and conducting a follow-up call 48 hours later, DeKalb Medical has been able to boost patient care and satisfaction.
"We joke that when patients hear the word discharge, they stop listening," says Joel Wright, vice president of health systems operations for Walgreens. "So, by contacting them 48 hours later, when they're back in a safe environment in their home and more ready to receive information, we can provide that in a way that's more meaningful to them."
The National Association of Chain Drug Stores estimates that poor medication adherence costs the U.S. health care system $290 billion. Nearly one-third of new medication orders go unfilled, according to a study of electronic prescriptions published by the Journal of General Internal Medicine in 2010.
Officials at DeKalb Medical, a 627-bed health system in Decatur, Ga., approached Walgreens, which has an on-site pharmacy, to help. After just 90 days, Hospital Consumer Assessment of Healthcare Providers Systems scores related to communication on medication rose from 50 to 63 percent, and they've stayed steady over the first year of the initiative.
Rather than sending a patient to pick up his medication, a staffer goes down to the pharmacy, brings it to the bedside and makes a follow-up call two days later to see if there are any issues, all at no extra fee.
Cost is another barrier, and Walgreens and DeKalb hook up departing patients with assistance programs to tackle a co-pay or find less pricey alternative drugs.
"Just getting it for them and having us pay for it with discharge assistance isn't going to solve the problem of keeping the patient on it for the next year," says Jackie Paynter, R.N., executive director of quality and care management for Dekalb Medical. "We'll pay for this prescription, but what will happen next month? It's better for us to find a therapeutic equivalent that the patient can afford and adhere to."
Paynter says they're compiling data to assess if the program is impacting avoidable readmissions. They've been using similar delivery methods in physician practices and outpatient surgery units. Walgreens is doing the same at many of its other 150 pharmacies located at hospitals across the country, but the program in DeKalb is one of the first where measurable results are starting to come in, says Wright.
On a larger scale, the American Society of Health System Pharmacists and the American Pharmacists Association are asking members for suggestions on best practices for medication-related transitions of care. They plan to issue a summary report sometime this fall.