Improving preoperative medication compliance with standardized instructions. Minerva Anestesiol 2016 Jan;82(1):44-9
Date
04/25/2015Pubmed ID
25907577Scopus ID
2-s2.0-84957991305 (requires institutional sign-in at Scopus site) 12 CitationsAbstract
BACKGROUND: Patient medication adherence in the perioperative setting is challenging, and failure to comply with medication instructions has serious clinical consequences. Many factors contribute to medication nonadherence, but a modifiable cause is inadequate physician instruction of patients. Variable formats, language and legibility impede patient-physician communication regarding proper use of medications. We hypothesized that the use of a standardized, electronic medical record (EMR)-derived medication instruction template would improve medication compliance on the day of surgery.
METHODS: As part of an ongoing quality improvement program, our institution surveyed patient's compliance with preoperative medication instructions. A standardized template was then created within the EMR and implemented by all providers in the preoperative evaluation clinic. Compliance with medications on the morning of surgery was then reassessed by preoperative nursing staff for three months shortly after the intervention and again two years later.
RESULTS: Patient adherence to preoperative medication instructions improved significantly immediately after the implementation of the template (from 83.7% to 89.7%, P=0.025). This improvement was also sustained at the two-year follow-up. Although patients' had overall good medication compliance (90% after the intervention), 71% of medication errors were made with medications with significant potential for causing complications (e.g., antithrombotic therapy).
CONCLUSION: Use of standardized, EMR-generated preoperative instructions improves patient medication adherence on the morning of surgery. Even with this intervention, medication nonadherence most often involves medications that could seriously interfere with perioperative care.
Author List
Pfeifer K, Slawski B, Manley AM, Nelson V, Haines MAuthors
Victoria R. Nelson APP Lead Outpatient in the Medicine department at Medical College of WisconsinKurt J. Pfeifer MD Professor in the Medicine department at Medical College of Wisconsin
Barbara A. Slawski MD Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
FemaleHumans
Male
Medication Adherence
Medication Errors
Middle Aged
Patient Education as Topic
Preoperative Care
Retrospective Studies
