Bedside medication delivery programs: suggestions for systematic evaluation and reporting

Agarwal, Parul; Poeran, Jashvant; Meyer, Joanne M.; Rogers, Linda; Reich, David L.; Mazumdar, Madhu

doi:10.1093/intqhc/mzz014

Cited by 5 publications

(8 citation statements)

References 21 publications

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“…In addition to biomedical care, additional supportive care programs are provided in many therapeutic areas. Such programs aim at improving therapy adherence [ 3 , 4 ], intend to stimulate self-management [ 5 – 7 ], or self-care [ 8 , 9 ], or may be directed at improving life-style related aspects, such as physical fitness, or diet-related recommendations [ 10 – 12 ]. There is a general agreement that programs, to be efficient and effective, should ideally suit the needs, wants and wishes of individual health-care consumers [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Segmentation of health-care consumers: psychological determinants of subjective health and other person-related variables

Bloem

Stalpers

Groenland

et al. 2020

BMC Health Serv Res

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Background: There is an observable, growing trend toward tailoring support programsin addition to medical treatmentmore closely to individuals to help improve patients' health status. The segmentation model developed by Bloem & Stalpers [Nyenrode Research Papers Series 12:1-22, 2012] may serve as a solid basis for such an approach. The model is focused on individuals' 'health experience' and is therefore a 'cross-disease' model. The model is based on the main psychological determinants of subjective health: acceptance and perceived control. The model identifies four segments of health-care consumers, based on high or low values on these determinants. The goal of the present study is twofold: the identification of criteria for differentiating between segments, and profiling of the segments in terms of socio-demographic and socioeconomic variables. Methods: The data (acceptance, perceived control, socioeconomic , and socio-demographic variables) for this study were obtained by using an online survey (a questionnaire design), that was given (random sample N = 2500) to a large panel of Dutch citizens. The final sample consisted of 2465 participantsage distribution and education level distribution in the sample were similar to those in the Dutch population; there was an overrepresentation of females. To analyze the data factor analyses, reliability tests, descriptive statistics and t-tests were used. Results: Cutoff scores, criteria to differentiate between the segments, were defined as the medians of the distributions of control and acceptance. Based on the outcomes, unique profiles have been formed for the four segments: 1. 'Importance of self-management'relatively young, high social class, support programs: high-quality information. 2. 'Importance of personal control'relatively old, living in rural areas, high in homeownership; supportive programs: developing personal control skills. 3. 'Importance of acceptance'relatively young male; supportive programs: help by physicians and nurses. 4. 'Importance of perspective and direction'female, low social class, receiving informal care; support programs: counseling and personal care. Conclusions: The profiles describe four segments of individuals/patients that are clearly distinct from each other, each with its own description. The enriched descriptions provide a better basis for the allocation and developing of supportive programs and interventions across individuals.

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Section: Introductionmentioning

confidence: 99%

Segmentation of health-care consumers: psychological determinants of subjective health and other person-related variables

Bloem

Stalpers

Groenland

et al. 2020

BMC Health Serv Res

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“…Given that each hospitalization costs approximately $11,700, this service potentially results in an annual savings of approximately $3 million in avoidable hospitalization costs. 4 Although there have been multiple studies published on the effect of medication bedside delivery programs, there has been a need for more intensive peer-reviewed studies with objective and systematic methodology as noted by Agarwal et al 9 in a recent 2019 publication. Our study's statistical analysis approach with intensive matching and weighting decreased the likelihood of confounders being present within the population.…”

Section: Science and Practicementioning

confidence: 99%

“…A recent study conducted at a large academic medical center initially found that patients who used a bedside medication delivery program as an isolated service were less likely to have a hospital readmission at 30 days. 9 However, once baseline characteristics were accounted for through a multivariate analysis between groups, bedside delivery was not a significant predictor of 30-day hospital readmission. These findings contradict previous findings that a medication bedside delivery program as part of a TOC program has an impact on the reduction in 30-day readmission rates seen with pharmacy-led TOC programs.…”

mentioning

confidence: 92%

“…6 Pharmacy-led TOC programs have been shown to reduce 30-day hospital readmission rates. 7,8 However, as discussed by Agarwal et al, 9 past studies demonstrating this benefit lacked a broad range of outcomes, including longterm benefits and the financial impact and overall value medication bedside delivery programs hold for health care institutions. 7 In addition, little data currently exist examining medication bedside delivery as an isolated service rather than part of a comprehensive TOC program.…”

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confidence: 99%

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Impact of medication bedside delivery program on hospital readmission rates

Witcraft¹,

Norris²,

Fudzie³

et al. 2021

Journal of the American Pharmacists Association

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“…Hospital systems have implemented numerous strategies to improve transitions of care and medication adherence, including bedside medication delivery and pharmacy-driven programs 9 . A 2019 systematic review of bedside medication delivery found limited peer-reviewed quantitative data evaluating the impact of medication delivery programs on readmissions and patient outcomes 10 . One study showed a nonsignificant decrease in 30-day readmissions after the implementation of a pharmacy program that provided medication reconciliation, education at discharge, medication delivery at the bedside, and follow-up telephone calls 11 .…”

mentioning

confidence: 99%

Meds to Beds at Hospital Discharge Improves Medication Adherence and Readmission Rates in Select Populations

Stedge¹,

Kubes³

et al. 2023

Southern Medical Journal

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Objectives: Medication nonadherence caused by difficulty obtaining and paying for medicines can increase hospital readmissions. This project implemented Medications to Beds ("Meds to Beds," M2B), a multidisciplinary predischarge medication delivery program, at a large urban academic hospital that provided subsidized medications for uninsured and underinsured patients to reduce readmissions.Methods: This 1-year retrospective analysis of patients discharged from the hospitalist service after implementing M2B contained two groups: one with subsidized medications (M2B-S) and one with unsubsidized medications (M2B-U). Primary analysis was 30-day readmission rates for patients, stratified by Charlson Comorbidity indexes (CCIs) of 0, 1-3, ≥4 to represent low, medium, and high comorbidity burden. Secondary analysis included readmission rates by Medicare Hospital Readmission Reduction Program diagnoses.Results: Compared with controls, the M2B-S and M2B-U programs had significantly reduced readmission rates among patients with CCIs of 0 (10.5% [controls] vs 9.4% [M2B-U] and 5.1% [M2B-S], P < 0.05). A nonsignificant reduction occurred in readmissions for patients with CCIs ≥4 (20.4% [controls] vs 19.4% [M2B-U] vs 14.7% [M2B-S], P < 0.07). Patients with CCIs of 1 to 3 showed a significant increase in readmission rates in the M2B-U, but a decrease in readmission rates among the M2B-S (15.4% [controls] vs 20% [M2B-U] vs 13.1% [M2B-S], P < 0.05). Secondary analyses found no significant differences in readmission rates when patients were stratified by Medicare Hospital Readmission Reduction Program diagnosis. Cost analyses demonstrated that subsidizing medicines cost less per patient for every 1% readmission reduction than delivery alone.Conclusions: Providing medicine to patients predischarge tends to lower readmission rates for populations with no comorbidities or with a high burden of disease. This effect is amplified when prescription costs are subsidized.

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Bedside medication delivery programs: suggestions for systematic evaluation and reporting

Cited by 5 publications

References 21 publications

Segmentation of health-care consumers: psychological determinants of subjective health and other person-related variables

Segmentation of health-care consumers: psychological determinants of subjective health and other person-related variables

Impact of medication bedside delivery program on hospital readmission rates

Meds to Beds at Hospital Discharge Improves Medication Adherence and Readmission Rates in Select Populations

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