Category: Fellows Posters
Purpose: Medication non-adherence is particularly problematic in older adults with multiple chronic medical conditions (MCMCs), especially as a result of miscommunication that can occur during care transitions. The goal of the proposed project is to disseminate and evaluate effectiveness of the educational toolkit designed to improve adherence to complex medication regimens in older adults with MCMCs and a new prescription at the time of hospital discharge. The planned intervention aims to increase patients’ understanding and compliance to medication therapy, with the ultimate goal of decreasing preventable hospital readmissions.
Methods: Proposed project is pending submission to the Institutional Review Board of Washington State University. We plan to recruit 121 participants with a gender ratio and racial/ethnic representation corresponding to the general demographics of rural eastern Washington State. Inclusion criteria for participants are age ≥60 years, ability to read/speak/listen and understand English, residence in a rural area, ≥2 chronic medical conditions diagnosed at baseline, regimen of ≥5 medications at baseline, ≥1 medication added during last hospital visit, undergoing transition of care from the hospital, and referral to participate in the study by a health care provider. Eligible patients provided informed consent will be randomly assigned to either control or intervention arm of the study. The intervention arm will be educated with a toolkit designed to facilitate patient-provider communication with the aim of improving medication adherence and receive standard transitional care by the primary care clinic of the hospital. The control arm will only receive standard transitional care. The toolkit, offered to the intervention arm, consists of a series of video vignettes highlighting negative and positive patient-provider interactions in combination with a conversation card addressing critical points of patient-provider discussion regarding the newly added medication therapy. The number of readmissions will be determined via review of hospital records at 30, 60, 90, 180 and 365 days post-intervention. Impact of the intervention on rehospitalization rates will be assessed.