Interventions improve medication adherence but don't affect readmissions

A targeted intervention for high-risk heart failure patients increased medication adherence, but had little effect on hospital readmissions, according to a new study from Duke Medicine.

The results suggest that medication adherence is only one of many factors that contribute to these patients' conditions worsening, Bradi B. Granger, Ph.D., director of Duke's Heart Center Nursing Research Program, said in the study announcement.

"We found that we could solve much of the problem around medication adherence, but that is not the whole issue," said Granger. "This illuminates the opportunities we have to help patients in a much broader way, redesigning care to confront some of the issues that keep the most vulnerable patients from regaining their health."

For the study, 86 heart failure patients at high risk for not taking their medications were randomly placed in one of two groups. Nurses regularly contacted and coached one group on adherence, but only contacted the other group without providing the coaching. Nurses regularly asked participants in both groups about their symptoms and their typical responses to them. Several patients stopped taking their medications after seeing no improvement in their symptoms, and often went to the emergency room when symptoms worsened.

Patients who received coaching were four times as likely to stay on their medications as the comparison group, according to the study, but in terms of readmissions, there was no significant difference. This unexpected result, Granger said, prompts the need for further study.

"Our next area of study will focus on the complex factors that affect the patient experience and lead to the avoidable use of emergency health care resources," she said. "We thought it was medication adherence in large part, but it might be that many of the same social and economic factors causing health disparities may also contribute significantly to high resource use."

A June report from the National Community Pharmacists Association found that the average American received a grade of C+ on medication adherence, with one in seven receiving a failing grade. Failure to adhere costs the healthcare system an estimated $290 billion per year, FierceHealthcare previously reported.

To learn more:
- read the research announcement