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Improving preoperative medication compliance with standardized instructions.

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Standardized electronic medical record (EMR) instructions improved patient medication adherence before surgery. This enhancement in preoperative medication compliance was sustained long-term, though high-risk medications still posed challenges.

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Area of Science:

  • Perioperative Medicine
  • Health Informatics
  • Patient Safety

Background:

  • Patient medication adherence in the perioperative setting is a significant challenge with serious clinical consequences.
  • Inadequate physician instructions and poor communication formats contribute to medication nonadherence.
  • Electronic Medical Record (EMR) systems offer potential solutions for improving patient instruction.

Purpose of the Study:

  • To evaluate the impact of a standardized EMR-derived medication instruction template on patient adherence.
  • To assess the sustainability of improved medication compliance over time.

Main Methods:

  • A quality improvement initiative involved surveying patient compliance with preoperative medication instructions.
  • A standardized template was developed within the EMR and implemented by all providers.
  • Compliance was reassessed shortly after implementation and again two years later.

Main Results:

  • Patient adherence improved significantly from 83.7% to 89.7% post-intervention (P=0.025).
  • This improvement in preoperative medication adherence was sustained at the two-year follow-up.
  • Medication errors, particularly with high-risk drugs like antithrombotics, remained a concern (71% of errors).

Conclusions:

  • Standardized, EMR-generated preoperative medication instructions effectively enhance patient adherence on the day of surgery.
  • While the intervention improves overall compliance, careful attention to high-risk medications is still crucial.
  • EMR integration can be a valuable tool for improving perioperative medication management.