Healthcare News & Insights

2 tactics to get patients to pick up medication after discharge

Hospitals need to make sure patients stay healthy after they’re discharged. One aspect of that is medication management, giving them the prescriptions they need so they can take the drugs as directed. But that’s easier said than done in many cases. 

ThinkstockPhotos-152110776Surprisingly, many patients don’t pick up necessary prescriptions at the pharmacy after being discharged from the hospital.

Past research shows that, after patients are released from the emergency department (ED), close to 35% fail to obtain the drugs that are most crucial to their recovery, such as antibiotics.

According to an article from KevinMD written by Dr. Alister Martin, a resident physician from Harvard, this is often attributed to financial issues. The logic goes that patients don’t pick up their prescriptions because they can’t afford to do so.

However, there’s more to the problem than just cost. Even in areas where more residents are affluent, prescription pick-up rates aren’t much better.

In his article, Dr. Martin cites a study in Boston where 32% of families failed to fill a child’s prescriptions after visiting the pediatric ED. In this study, factors such as cost, low health literacy or access to primary care had no effect on whether a family was more likely to fill the prescription.

So facilities may need to dig deeper to improve medication adherence after discharge. Dr. Martin’s idea: Hospitals may be able to boost these rates by using tactics often employed by political campaigns, specifically regarding the study of behavior economics.

Influencing behavior

According to Dr. Martin, behavior economics look into how people think and make decisions. Applying that knowledge to the decision-making process behind filling prescriptions can provide insight into why patients don’t end up getting their medications.

Most of the time, patients do intend to get their prescriptions. But for whatever reason, they don’t act on their intentions. Life gets in the way, and they forget. Or the person’s getting better, so they don’t see the need for the drug. This is referred to as the “action-intention gap.”

In politics, action-intention gaps are seen with voters. They express a desire to visit the polls, but they don’t end up voting.

To close these gaps, campaigns have used “implementation intentions,” or a goal-setting strategy that specifies the “where, when and how” behind the intended behavior.

As a way of getting potential voters to make a “voting plan,” campaign volunteers asked them three questions:

  • What time are you voting?
  • Where are you coming from?
  • What will you be doing beforehand?

These questions were designed to create a mental link in voters’ brains between the intended outcome (voting) and the actions they’ll be doing beforehand. The preceding events act as “triggers” in the person’s mind, so they’ll associate them with the action of voting and carry it out naturally.

Asking these questions helped boost voter turnout by 4.1% – a number that seems small, but could change the outcome of an election in close races.

And for the minimal amount of effort it takes, the strategy’s worth using for hospitals, says Dr. Martin.

Hospitals could incorporate the three questions into their discharge process, asking patients what time they’ll pick up their medication, where they’ll be beforehand and how they’ll get there. These questions could subconsciously encourage patients and their families to pick up medications.

Another strategy to try: using the “threat of accountability,” where it’s implied that some sort of follow-up will occur that’s directly related to the action you want the person to take.

With political campaigns, this concept was used successfully when volunteers sent voters mailings that included this sentence: “We may call you after the election to talk about your voting experience.” Voters who received this mailing were almost 50% more likely to vote.

Per Dr. Martin, hospitals could include a similar sentence in the patient’s discharge summary about picking up their medications, letting them know that a staff member may reach out and ask them about their experience with the drug after they started taking it.

These two small “nudges” could make a big difference in improving medication pickup rates and adherence, leading to fewer negative outcomes, such as readmissions, that can hurt a hospital’s bottom line.

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