Coaching Patients on Medications
by Teddi Fine
Hospital discharge marks a transition from care by an expert health team to home-based self-care. From a nursing perspective, discharge of a patient with multiple chronic illnesses and an arsenal of medications is a step into the unknown. Will the patient manage medications adequately or be caught in a revolving door of chronic discharge and rehospitalization?
According to Johns Hopkins Hospital nurse Linda L. Costa, PhD, RN, NEA-C, “As the population ages, this reality can affect growing numbers of Americans. If patients with chronic illnesses don’t understand how and when to take their medications, they can’t manage their illnesses.”
That’s why Costa partnered with hospital colleague Stephanie S. Poe, DNP, RN, and doctoral student Mei Ching Lee, MS, BSN, to compare the value of telephone “check-ins” and home-based “drop-ins” to coach proper medicine use by recently discharged patients taking 8 to10 medications daily. [“Challenges in Posthospital Care: Nurses as Coaches for Medication Management,” Journal of Nursing Care Quality, January 2011.]
Their findings? Being there matters. Two-thirds more medication discrepancies were uncovered in home visits than in phone interviews. Patients were better at taking their meds when nurses had provided in-person tips and coaching on managing the drug routine. Costa hopes that studies like this will help improve medication compliance that will not only foster better health, but also reduce the risks of rehospitalizations and unnecessary healthcare costs.