The Impact of Medication Synchronization on Proportion of Days Covered within the Pediatric Setting

Brooke E. Maletic, Alex Swick, Leanne J. Murray, Mahmoud Abdel-Rasoul, Ashley Braughton, Kayla Petkus
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Abstract

Introduction: Poor adherence to medication regimens accounts for the substantial worsening of disease, death, and increased healthcare costs of approximately $100 billion annually in the United States. Patients participating in medication synchronization had 3.4 to 6.1 times increased odds of adherence, depending on the drug class. Abundant literature supports medication synchronization within the adult population. This IRB-exempt, prospective quality improvement project is an example of implementing and assessing medication synchronization inclusive of the pediatric setting. Methods: This study is a single-center, prospective, quality improvement project for patients seen at Nationwide Children’s Hospital (NCH) Complex Care Clinic that also fill prescriptions at NCH Outpatient Pharmacies. The project assessed patient medication adherence using the Proportion of Days Covered and the number of trips to the pharmacy 90 days before and 90 days postimplementation. We also assessed patient and pharmacy staff satisfaction 3 months after project implementation. Results: There was a statistically significant increase in the number of days covered for patients 90 days postimplementation compared to 90 days before implementation (Difference: 3.60; 95% confidence interval: 1.87, 5.33; P = 0.001). Additionally, there was a statistically significant decrease in pharmacy trips pre- and postimplementation (Difference: 2.17; 95% confidence interval: 1.26, 3.07; P < 0.001). Overall, pharmacy staff and patients reported satisfaction with the service. Conclusions: Implementing a medication synchronization service improved medication adherence and decreased trips to the pharmacy within the pediatric population.
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同步用药对儿科住院天数比例的影响
在美国,对药物治疗方案的依从性差导致疾病和死亡的严重恶化,并增加了每年约1000亿美元的医疗保健费用。根据药物种类的不同,参与药物同步治疗的患者坚持服药的几率增加了3.4到6.1倍。大量文献支持成人用药同步。本irb豁免,前瞻性质量改进项目是实施和评估包括儿科设置的药物同步的一个例子。方法:本研究是一项单中心、前瞻性、质量改进项目,研究对象是在全国儿童医院(NCH)综合护理诊所就诊的患者,这些患者也在NCH门诊药房配药。该项目使用覆盖天数比例和实施前90天和实施后90天去药房的次数来评估患者的服药依从性。在项目实施3个月后,我们还评估了患者和药房工作人员的满意度。结果:与实施前90天相比,实施后90天患者的覆盖天数有统计学意义的增加(差异:3.60;95%置信区间:1.87,5.33;P = 0.001)。此外,在实施前和实施后,去药房的次数也有统计学意义上的显著减少(差异:2.17;95%置信区间:1.26,3.07;P < 0.001)。总体而言,药房工作人员和患者对服务表示满意。结论:在儿科人群中实施药物同步服务提高了药物依从性并减少了去药房的次数。
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