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Objective: Among patients discharged from the hospital with changes in maintenance prescription medication, how does experiencing a medication access gap compared to a no medication access gap impact the time to first unplanned healthcare encounter?
This is a retrospective, cohort study conducted at two hospital sites in rural Pennsylvania and New York State using encounter data from the electronic health record to analyze any patient discharged with medication changes from June 1, 2023 to May 31, 2024.
Background: Transitions of care are high-risk periods marked by frequent medication-related problems with up to 80% of discharged patients and 98% of older adults experiencing discrepancies in their medication regimens. These gaps, often due to delayed prescription refills or poor care coordination, contribute to unplanned healthcare encounters, increased costs, and strain on providers. Pharmacists can mitigate these risks by improving medication access and continuity.
Objective: Among patients discharged from the hospital with changes in maintenance prescription medication, how does experiencing a medication access gap compared to a no medication access gap impact the time to first unplanned healthcare encounter?
This is a retrospective, cohort study conducted at two hospital sites in rural Pennsylvania and New York State using encounter data from the electronic health record to analyze any patient discharged with medication changes from June 1, 2023 to May 31, 2024.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Medication Gap | A patient with a medication gap was defined as 1) having lapse in prescription coverage or any number of days where they were out of a maintenance prescription medication because the primary care provider did not send in a refill in time, and 2) having a medication access barrier, such as needing to contact the primary care provider to send in a refill for a maintenance prescription medication. |
| |
| No Medication Gap | A patient with no medication gap was defined as having zero days without a maintenance prescription medication because it was appropriately refilled by their primary care provider at a transitions of care follow-up appointment |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Unplanned healthcare encounter | Behavioral | Patient needing to connect with healthcare to fill a medication gap |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of days to first unplanned healthcare encounter post-discharge | The study will compare number of days between patients who had a medication gap and patients who had no medication gap | 90 days after discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Number of days that a patient is without a prescribed medication post-discharge | The study will compare the number of days patients are without a prescribed medication after hospital discharge, for the two groups (1 patients who had a medication gap and 2 patients who had no medication gap). | 90 days after discharge |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients discharged from an acute care hospital with a change in their chronic prescription medication regimen
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| Name | Affiliation | Role |
|---|---|---|
| Alison Van Dyke, PharmD | The Guthrie Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Robert Packer Hospital | Sayre | Pennsylvania | 18840 | United States |
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| Describe the types of drug-related problems and/or medication access barriers between the two groups |
The study will compare the types of drug-related problems and medication access barriers between the two groups (1 patients who had a medication gap and 2 patients who had no medication gap). |
| 90 days after discharge |