Improved adherence, med management can reduce hospital re-admissions, healthcare group says
CAMBRIDGE, Mass. — Improving medication adherence may be the key to reducing hospital re-admission rates, according to a new issue brief by a health policy research organization.
NEHI issued the brief Friday, saying that incorporating medication adherence policies into discharge planning was important as earlier this month, hospitals began facing federal penalties for Medicare patients re-admitted for heart attack, heart failure and pneumonia within 30 days of discharge. Hospital re-admissions cost the healthcare system $25 billion per year, while medication nonadherence costs $290 billion, according to NEHI research.
Successful new models of advanced discharge planning and transitional care, NEHI said, include accountability for medication-related tasks in which care coordinators own the medication-management process; teamwork to coordinate professionals inside and outside the hospital; medication reconciliation for medications patients might be taking that hospital staff don’t know about; direct engagement with patients and caregivers; and follow-ups with patients after discharge.
"Medication management and improved adherence are critical tools for lowering readmissions," NEHI executive director Valerie Fleischman said. "And new models of hospital discharge planning are showing the way."
Earlier this week, Walgreens announced WellTransitions, which brings together the retailer, hospitals and health systems in a coordinated care model designed to reduce re-admissions through MTM and improvements to adherence.
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WellTransitions couldn’t be more timely with a well-vetted solution to reducing hospital re-admissions
WHAT IT MEANS AND WHY IT’S IMPORTANT — WellTransitions could be couched as another way in which Walgreens is striving to create solutions that lower the cost of overall health care outside of the physical retail pharmacy space, because it is. WellTransitions also could be characterized as a program that will routinely chip away at the $25 billion associated with hospital re-admissions by having more prescriptions filled at the pharmacy counter, because it does. But the real impact of this news? The real clincher? Hospitals need retail pharmacy if they’re going to focus on reducing re-admissions, eliminating unnecessary healthcare costs and avoiding those penalties.
(THE NEWS: Walgreens introduces WellTransitions, a coordinated care model that works in tandem with hospitals. For the full story, click here.)
And that’s the direction Walgreens is headed. Most recently, the company added managed care vet Brad Fluegel as chief strategy officer, adding another talented expert to Walgreens chief Greg Wasson’s dream team, which he has described as the “perfect blend of internal, long-term talent” and “external expertise and talents” that is helping to accelerate a massive transformation in its business. (For exclusive coverage of all Walgreens’ efforts, click here for the Sept. 24 DSN special report.)
For the first year, hospitals are only being measured on 30-day re-admissions across three medical conditions: heart attacks, heart failure and pneumonia. Taking re-admission rates around heart attacks as an example, heart attacks are among the top 10 reasons for hospitalization among adults ages 45 years and older, according to a statistical brief recently issued by the Healthcare Cost and Utilization Project — a family of healthcare databases and related software tools and products developed through a federal/state/industry partnership and sponsored by the Agency for Healthcare Research and Quality. In 2009, there were 633,000 patients admitted for acute myocardial infarction. Close to 1-in-5 of those patients, or 17.1%, were re-admitted to the hospital within 30 days.
Medication therapy management isn’t a magic wand, mind you. But it can be a hefty tool that if employed properly can take a significant swipe at reducing that readmission statistic. And a lot of hospitals aren’t focused effectively on medication therapy management.
According to a study published in the August 2012 issue of the Journal of the American College of Cardiology, a significant number of hospitals failed to employ medication therapy management as a tool to help boost medicine adherence and consequently reduce re-admission rates. In about 14% of hospitals, responsibility for medication reconciliation was never formally assigned. “For nearly one-half of the hospitals, a pharmacist or pharmacy technician was never involved with obtaining the medication history, and a small proportion of hospitals reported always making contact with an outside pharmacy or with the primary physician as part of the medication reconciliation process (in 3.2% and 13.9% of hospitals, respectively),” the report read. “Although patient education about medications was apparently robust, with 70% of hospitals reporting the use of ‘teach-back’ techniques and 77% reporting that all medication details were given to patients at discharge, lack of standard processes for both the reconciliation and patient education regarding medications is potentially problematic.”
But why might these practices be lacking in so many hospitals? “One reason might be because they require added resources,” the authors concluded. “Particularly in the case of producing timely discharge summaries and ensuring adequate patient and caregiver education about complex medication and other issues, it is possible that constraints on staff time is a major rate-limiting step to implementing some of these potentially best practices.”
A pharmacy can help solve that problem.
According to a study published in Circulation, the journal of the American Heart Association, nonadherence to medications is common for patients with cardiovascular diseases. Almost 1-in-4 never filled their prescriptions. Among patients discharged with prescriptions for aspirin, statin and beta blockers, almost 34% of patients stopped taking at least one of those medicines within a month after discharge, and 12% had stopped taking all three.
And the fact that a pharmacist intervention can produce the desired results has been long documented. In a 2007 study published in the Annals of Internal Medicine, there was a 19.4% reduction hospital readmissions in patients seen by pharmacists.
Wow! So well laid out!on topic WellTransitions couldn't be more timely with a well-vetted solution to reducing hospital re-admissions I learned so much, and have to admit, found myself nodding in agreement from my own experience.Keep up the great work!
Pharmacy OneSource releases new version of Simplifi 797 pharmacy compounding software
BELLEVUE, Wash. — A division of Wolters Kluwer Health has released a new version of a Web-based quality-assurance software for pharmacy compounding.
Pharmacy OneSource announced the release of a new version of Simplifi 797, used for ensuring compliance with USP chapter 797 regulations, which call for proper training of staff who prepare sterile compounded products.
The software includes a redesigned dashboard that allows for tracking of competencies by separating them for each staff member. This allows assignments for the entire clean-room staff to be created or modified with just a few clicks, the company said.
The release of the new software comes amid a nationwide outbreak of meningitis that authorities say stemmed from compounded injectable steroids that were contaminated with a rare fungus from a New England-based compounding pharmacy. The outbreak so far has resulted in 257 cases and 20 deaths as of Friday, according to the Centers for Disease Control and Prevention’s daily update.
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