Increasing Medication Possession at Discharge for Patients With Asthma: The Meds-in-Hand Project

Pediatrics
Jonathan HatounJames Moses

Abstract

Many patients recently discharged from an asthma admission do not fill discharge prescriptions. If unable to adhere to a discharge plan, patients with asthma are at risk for re-presentation to care. We sought to increase the proportion of patients discharged from an asthma admission in possession of their medications (meds in hand) from a baseline of 0% to >75%. A multidisciplinary improvement team performed 3 plan-do-study-act cycles over 2 years and, using a statistical process control chart, tracked the proportion of patients admitted with asthma discharged with meds in hand as the primary outcome. An exploratory, retrospective analysis of insurance data was conducted with a convenience sample of Medicaid-insured patients, comparing postdischarge utilization between patients discharged with meds in hand and usual care. Generalized estimating equations accounted for nonindependence in the data. Changes to the discharge process culminated in the development of a discharge medication delivery service. Outpatient pharmacist delivery of discharge medications to patient rooms achieved the project aim of 75% of patients discharged with meds in hand. In a subset of patients for whom all insurance claims were available, those dischar...Continue Reading

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Citations

Mar 18, 2017·Current Opinion in Pediatrics·Erin K StensonDerek S Wheeler
Feb 14, 2018·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Chén C KenyonChris Feudtner
May 6, 2019·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Parul AgarwalMadhu Mazumdar
Jun 5, 2019·Clinical Transplantation·Lisa PotterUNKNOWN American Society of Transplantation Transplant Pharmacy Community of Practice
Aug 23, 2019·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Erik R HoefgenJeffrey Simmons
Jan 22, 2020·JAMA Pediatrics·Cristin Q FritzDavid Keller
Jun 5, 2020·Journal of Pharmacy Practice·Mary B Bridgeman, Lori A Wilken
Jul 16, 2020·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Kavita ParikhStephen J Teach
Apr 30, 2020·Journal of the Pediatric Infectious Diseases Society·Rachel L EpsteinEllen R Cooper
May 6, 2019·Hospital Pediatrics·Abigail LazarMd Jobayer Hossain
Nov 15, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Avni PatelPreeyaporn Sarangarm
Apr 14, 2021·Research in Social & Administrative Pharmacy : RSAP·Isha RanaSandra F Durley
Jun 1, 2021·Current Problems in Pediatric and Adolescent Health Care·Uchenna C Ewulonu, Heather Dyer
May 16, 2021·The Journal of Pediatrics·Alexander H HoganGlenn Flores
Nov 18, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Sandra E ZaehCynthia Rand
Feb 17, 2017·Pediatrics·Leah A MalloryUNKNOWN IMPACT Pilot Study Group
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Apr 7, 2018·Pediatrics·Kavita ParikhShawn Ralston
Feb 20, 2019·American Journal of Infection Control·Elijah VerheyenAri Grinspan

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