Article Text
PDF
Abstract
Background Lack of prescription adherence after discharge from the inpatient hospital setting is a barrier to the delivery of optimal patient care. Non-adherence to medication for cardiac diseases can lead to substantial morbidity, mortality and healthcare costs. Electronic delivery of prescriptions by fax is a potential method of improving patient satisfaction and reducing pharmacy wait times.
Methods This study was completed in the cardiology inpatient wards at a hospital in London, Ontario, Canada. ‘Delayed prescription retrieval’ was defined as the retrieval of a prescribed medication by a patient from their local pharmacy after the documented calendar day of discharge. The current discharge process on the cardiology wards was assessed and an initial monitoring period of study participants was completed to determine the baseline delayed prescription retrieval rate (preintervention group). A formalised discharge process, which included electronic delivery of prescriptions to pharmacies by fax, was implemented for study participants (postintervention group). The rate of delayed prescription retrieval was assessed in both groups.
Results 15 of 42 patients (35.7%) in the preintervention group and 9 of 72 (14.3%) in the postintervention group had delayed prescription retrieval suggesting relative and absolute risk reductions of 65% and 23.2% (p=0.0045). Of the participants with delayed prescription retrieval, 100% in the preintervention group and 77.8% in the postintervention group were due a new prescribed medication on the day of discharge.
Conclusions Patients who experienced a formalised discharge process, which included electronic delivery of prescriptions by fax, at the time of discharge from cardiac inpatient care had a lower rate of delayed prescription retrieval. Future studies are required to examine the impact of formal discharge processes on patient morbidity and mortality.
- electronic prescribing
- healthcare quality improvement
- patient discharge
- patient education
- quality improvement
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Footnotes
Twitter @agob2007
Contributors AKS designed and planned the study, assisted with data collection, data analysis, and manuscript preparation, and submitted the study. SM, MA and ML assisted with study design, planning and data collection. JL assisted with study design, planning and data analysis. AG assisted with study design, planning, data analysis and manuscript preparation. RM assisted with study design, planning, data analysis, manuscript preparation and submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Patient consent for publication Not required.
Ethics approval This study was classified as a quality improvement investigation based on the requirements listed in the Tri-Council Policy Statement (Article 1.1). The research team confirmed with the Research Ethics Board that articles classified as quality improvement investigations did not require ethics committee approval. The study process was also reviewed by the Privacy and Medical Affairs offices of the London Health Sciences Centre, where the study took place.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Deidentified individual participant data are stored in a password-protected database on our institution’s hospital server.