Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot study
Background: The mobile integrated health-community paramedicine (MIH-CP) program affiliated with the University of Maryland Medical Center focuses on improving patient transitions from hospital to home by addressing both medical and social determinants of health. Until recently, only self-contained...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Exploratory Research in Clinical and Social Pharmacy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667276622001007 |
| _version_ | 1811201585756241920 |
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| author | Olufunke Sokan Benoit Stryckman Yuanyuan Liang Sade Osotimehin Daniel B. Gingold Weston W. Blakeslee Matthew J. Moore Colin A. Banas Colleen T. Landi Magaly Rodriguez |
| author_facet | Olufunke Sokan Benoit Stryckman Yuanyuan Liang Sade Osotimehin Daniel B. Gingold Weston W. Blakeslee Matthew J. Moore Colin A. Banas Colleen T. Landi Magaly Rodriguez |
| author_sort | Olufunke Sokan |
| collection | DOAJ |
| description | Background: The mobile integrated health-community paramedicine (MIH-CP) program affiliated with the University of Maryland Medical Center focuses on improving patient transitions from hospital to home by addressing both medical and social determinants of health. Until recently, only self-contained health systems could integrate inpatient and outpatient medication data. Without some means to track patients in transition, there is a significant risk of medication-related problems and errors. Objective: To evaluate the impact of the MIH-CP program on medication adherence among patients with congestive heart failure (CHF) and/or chronic obstructive pulmonary disease (COPD). Methods: This is a pilot observational study designed to compare adherence to drug regimens prescribed at hospital discharge (measured by the proportion of days covered [PDC]) between patients enrolled in the MIH-CP program and a propensity-matched control group. Propensity scores were calculated using 11 demographic, diagnostic, third-party payer, and patient care-associated variables. Discharge medication details were obtained from electronic medical records. PDC for each of the medications were calculated from pharmacy claims data. Results: Eighty-three patients were included in the study; forty-three patients were placed in the intervention group and 40 were propensity-matched controls. After adjusting for age, sex, and third-party payer, findings indicated that medication adherence was higher among patients enrolled in the MIH-CP program compared with control during the first 30 days post-discharge, specifically among patients diagnosed with CHF (8% difference in PDC, 95% confidence interval [CI], ‐0.12-0.28%) and COPD (14% difference, 95% CI, ‐0.15-0.43%), although neither result achieved statistical significance. The differences in medication adherence between patients who were enrolled and those who were not enrolled in the MIH-CP program diminished after 30 days post-discharge. Conclusion: This pilot study demonstrated a trend toward improved medication adherence among patients enrolled in the MIH-CP program. Future research involving a larger patient cohort will be required to confirm these preliminary findings. |
| first_indexed | 2024-04-12T02:24:08Z |
| format | Article |
| id | doaj.art-329e39b759184ed5ba1905aa94085825 |
| institution | Directory Open Access Journal |
| issn | 2667-2766 |
| language | English |
| last_indexed | 2024-04-12T02:24:08Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Exploratory Research in Clinical and Social Pharmacy |
| spelling | doaj.art-329e39b759184ed5ba1905aa940858252022-12-22T03:52:02ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662022-12-018100201Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot studyOlufunke Sokan0Benoit Stryckman1Yuanyuan Liang2Sade Osotimehin3Daniel B. Gingold4Weston W. Blakeslee5Matthew J. Moore6Colin A. Banas7Colleen T. Landi8Magaly Rodriguez9Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, United States; Corresponding author at: 110 N. Pine St, Rm 105C, Baltimore, MD 21201, United States.Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, United StatesDepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United StatesDRFIRST.com, Inc., Rockville, MD, United StatesDRFIRST.com, Inc., Rockville, MD, United StatesDRFIRST.com, Inc., Rockville, MD, United StatesUniversity of Maryland Medical Center, Baltimore, MD, United StatesDepartment of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, United StatesBackground: The mobile integrated health-community paramedicine (MIH-CP) program affiliated with the University of Maryland Medical Center focuses on improving patient transitions from hospital to home by addressing both medical and social determinants of health. Until recently, only self-contained health systems could integrate inpatient and outpatient medication data. Without some means to track patients in transition, there is a significant risk of medication-related problems and errors. Objective: To evaluate the impact of the MIH-CP program on medication adherence among patients with congestive heart failure (CHF) and/or chronic obstructive pulmonary disease (COPD). Methods: This is a pilot observational study designed to compare adherence to drug regimens prescribed at hospital discharge (measured by the proportion of days covered [PDC]) between patients enrolled in the MIH-CP program and a propensity-matched control group. Propensity scores were calculated using 11 demographic, diagnostic, third-party payer, and patient care-associated variables. Discharge medication details were obtained from electronic medical records. PDC for each of the medications were calculated from pharmacy claims data. Results: Eighty-three patients were included in the study; forty-three patients were placed in the intervention group and 40 were propensity-matched controls. After adjusting for age, sex, and third-party payer, findings indicated that medication adherence was higher among patients enrolled in the MIH-CP program compared with control during the first 30 days post-discharge, specifically among patients diagnosed with CHF (8% difference in PDC, 95% confidence interval [CI], ‐0.12-0.28%) and COPD (14% difference, 95% CI, ‐0.15-0.43%), although neither result achieved statistical significance. The differences in medication adherence between patients who were enrolled and those who were not enrolled in the MIH-CP program diminished after 30 days post-discharge. Conclusion: This pilot study demonstrated a trend toward improved medication adherence among patients enrolled in the MIH-CP program. Future research involving a larger patient cohort will be required to confirm these preliminary findings.http://www.sciencedirect.com/science/article/pii/S2667276622001007Medication adherenceCommunity paramedicineMobile integrated healthTransition of careTelehealthData integration |
| spellingShingle | Olufunke Sokan Benoit Stryckman Yuanyuan Liang Sade Osotimehin Daniel B. Gingold Weston W. Blakeslee Matthew J. Moore Colin A. Banas Colleen T. Landi Magaly Rodriguez Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot study Exploratory Research in Clinical and Social Pharmacy Medication adherence Community paramedicine Mobile integrated health Transition of care Telehealth Data integration |
| title | Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot study |
| title_full | Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot study |
| title_fullStr | Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot study |
| title_full_unstemmed | Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot study |
| title_short | Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot study |
| title_sort | impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge a pilot study |
| topic | Medication adherence Community paramedicine Mobile integrated health Transition of care Telehealth Data integration |
| url | http://www.sciencedirect.com/science/article/pii/S2667276622001007 |
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