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Emergency Department Asthma Medication Delivery Program: An Initiative to Provide Discharge Prescriptions and
Kayla Durkin1, Tricia Montgomery1, Kristen Lamberjack1
1Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio; Quality Improvement Services Department, Nationwide Children's Hospital, Columbus, Ohio; Operations Department, TransChart, LLC, Dublin, Ohio; and Emergency Department, UCSF Benioff Children's Hospital, Oakland, Calif.
Insights
A new emergency department (ED) asthma prescription delivery service increased medication adherence for children. However, the service did not significantly reduce asthma-related ED revisits, though patient satisfaction was high.
Area of Science:
- Pediatric Emergency Medicine
- Asthma Management
- Healthcare Delivery Systems
Background:
- Low prescription fill rates for pediatric asthma exacerbations discharged from the emergency department (ED) increase readmission risks.
- A novel ED asthma prescription delivery service was implemented to improve medication adherence and reduce revisits.
Purpose of the Study:
- To evaluate the impact of an ED-based asthma prescription delivery service on medication fill rates.
- To assess the effect of the service on 7-, 14-, and 30-day ED revisit rates for pediatric asthma patients.
- To determine patient satisfaction with the asthma prescription delivery service.
Main Methods:
- A service was developed to provide asthma prescriptions and education to patients in the ED room prior to discharge.
- The study assessed prescription fill rates at the hospital outpatient pharmacy.
- ED revisit rates and patient satisfaction were monitored for participants receiving the service versus standard care.
Main Results:
- A statistically significant increase in filled asthma prescriptions was observed (22.2% vs. 33.8%, P < 0.0001).
- No significant reduction in 7-, 14-, or 30-day ED revisit rates was found for patients using the delivery service compared to standard care.
- Patients reported high satisfaction levels with the service.
Conclusions:
- Implementation of an ED medication delivery program significantly increased the percentage of pediatric asthma patients filling prescriptions.
- The asthma prescription delivery service did not demonstrate a statistically significant impact on ED revisit rates.
- The service was well-received by patients, indicating potential for improved medication adherence in pediatric asthma care.
Background:
Prescription fill rates for children being discharged from the emergency department (ED) after asthma exacerbations are low, placing the child at risk for additional ED visits or admissions for asthma. This article describes the implementation of an ED asthma prescription delivery service designed to improve pharmacy prescription capture and decrease ED revisit rates.
Methods:
A core group developed a service to provide asthma prescriptions and education to patients in their ED room before discharge. The project assessed the percent of ED asthma patients who filled ED asthma prescriptions at the hospital outpatient pharmacy, 7-, 14-, and 30-day ED revisit rates, and patient satisfaction.
Intervention:
Patients/families who chose to participate in the service received asthma prescriptions and education at the ED bedside. Within 1-3 days, ED outreach nurses obtained patient satisfaction survey responses via telephone.
Results:
There was a statistically significant increase in the number of patients who filled ED asthma prescriptions at the hospital outpatient pharmacy (22.2% versus 33.8%; P < 0.0001). The decrease in 7-, 14-, or 30-day ED revisit rates for patients who received the medication delivery service compared with standard of care was not statistically significant. Patients were satisfied to very satisfied with the service.
Conclusion:
Postimplementation of a medication delivery program within the ED, there was an increase in the percentage of patients who filled ED asthma medication prescriptions at the hospital outpatient pharmacy. There was no difference in ED revisit rates for patients who enrolled in the prescription delivery service versus standard of care.
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