Automated follow-up helps spot adverse drug reactions

A new study from Ottawa Hospital in Canada using an automated phone system reiterates that follow-up with patients can improve medication adherence--and flag adverse reactions.

Researchers used a system called ISTOP-ADE that called patients three days after they received a prescription, and again after 17 days, according to the research, published at JAMA Internal Medicine. The authors said patients must be given more opportunities to ask questions about their medications.

Of 628 patients from 76 physician practices, the system was able to reach 465 at three days, and 475 at 17 days. The patients were asked whether they had a problem filling a prescription and taking the medication, had new symptoms and whether they wanted to talk to a pharmacist. One-third of patients asked to speak to a pharmacist, who then called back.

At 21 days, all of the patients were interviewed about their medication use, symptoms and healthcare visits. That information was collated with their electronic health records and the results of the automated calls.

The system identified 46 percent of adverse drug events and influenced how 40 percent of those were managed, reports CBC News.

In a related editorial, Michael Steinman, M.D., of the Department of Medicine at the University of California-San Francisco, called ISTOP-ADE system "exciting and highly promising." However, merely reaching out to patients isn't enough, he said; he urged providers to educate and encourage patients to be active partners in their own care.

A recent Michigan State University study looked at whether nurse follow-up or automated calls--or both--were more effective in improving medication adherence. As it turns out, all the models showed equal improvement.

Meanwhile, Israeli startup MediSafe Project says its mobile "pillbox app," which cloud syncs users' failure to take medication on time to their friends, family and caretakers, boosts medication adherence rates to 81 percent.

And while reminders are swell, better doctor-patient communication at the time the prescription is written is essential, according to research published last month from the University of California-San Francisco, San Francisco General Hospital and Trauma Center, and the Kaiser Permanente Division of Research.

"Communication matters," lead author Neda Ratanawongsa, a UCSF assistant professor, said. "By supporting doctors in developing meaningful relationships with their patients, we could help patients take better care of themselves."

To learn more:
- read the abstract
- here's the editorial
- here's the CBC News article


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