Boston—Patients hospitalized for asthma exacerbations often fail to fill discharge prescriptions, putting them at risk of needing emergency care or readmission.

With that understanding, a research team from Boston University and Boston Medical Center sought to increase the proportion of patients discharged from an asthma admission in possession of their medications—i.e., “meds in hand”—from a baseline of 0% to greater than 75%.

For the report published recently in Pediatrics, study authors conducted an exploratory, retrospective analysis of insurance data with a sample of Medicaid-insured patients. Postdischarge medication adherence between patients discharged with meds in hand and usual care were compared.

Among the changes to the discharge process was a service whereby outpatient pharmacists delivered medications to patient room, which met the goal of 75% of patients leaving the hospital with meds in hand.

In a subset of patients for whom all insurance claims were available, researchers found that those discharged with meds in hand had lower odds of all-cause re-presentation to the emergency department within 30 days of discharge, compared with patients discharged with usual care.

“Our initiative led to several discharge process improvements, including the creation of a medication delivery service that increased the proportion of patients discharged in possession of their medications and may have decreased unplanned visits after discharge,” study authors point out.

Previous studies have shown that adherence to asthma medications on average is far from optimal. Depending on methods, population and setting, estimates of nonadherence typically range between 30% and 75% in both adults and children, according to a report last year in Primary Care Respiratory Medicine.

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