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CDA 12-168 – HSR&D Study

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CDA 12-168
Optimizing Medication Reconciliation for Older Veterans in Home Health Care
Amanda S Mixon MD MSPH MS
Tennessee Valley Healthcare System Nashville Campus, Nashville, TN
Nashville, TN
Funding Period: September 2013 - March 2018

BACKGROUND/RATIONALE:
Medication reconciliation, the process of identifying the most accurate list of medications a Veteran should be taking, is a vital strategy to reduce potentially harmful medication discrepancies. After hospital discharge, home health clinicians are required to document discrepancies and alert the treating physicians; however, little is known about the effectiveness of resolving medication discrepancies in the home healthcare setting. Currently, there is no standardized way for home health clinicians to prioritize and communicate discrepancies promptly to the treating provider(s).

OBJECTIVE(S):
The goal of this research is to develop a standardized protocol for prioritizing and communicating medication discrepancies identified in the home healthcare setting.

METHODS:
Aim 1: Document variation in home health medication reconciliation using both qualitative and quantitative methods to determine the variation in current practice. Data collection on Veterans receiving home health including phone calls, determination of medication discrepancies, chart abstraction, and surveys of VA community health nurses.
Aim 2: Interview health care providers to refine a protocol for identifying and prioritizing medication discrepancies as well as a structured communication tool to improve timely resolution of discrepancies.
Aim 3: Evaluate the feasibility, acceptability, and effectiveness of the protocol and communication tool on reducing the time to resolution of post-discharge medication discrepancies (main outcome) through a small cluster randomized trial.




FINDINGS/RESULTS:
Not yet available.

IMPACT:
1) Uncover practice variation of medication reconciliation in home healthcare; 2) Develop a structured protocol for home health clinicians to identify and prioritize medication discrepancies; 3) Adapt a communication tool for home health clinicians to relay discrepancies to both inpatient and outpatient providers; 4) Decrease the potential harm of medication discrepancies by resolving them more effectively; 5) Identify future opportunities for improving the processes and communication surrounding medication reconciliation in the home healthcare setting.

PUBLICATIONS:

Journal Articles

  1. Mixon AS, Poppendeck H, Kripalani S, Speroff T, Schnelle J, Dittus R, Roumie C. Medication Discrepancies in Older Veterans Receiving Home Healthcare. Home healthcare now. 2020 Jan 1; 38(1):31-39.


DRA: Aging, Older Veterans' Health and Care, Health Systems
DRE: Prevention, Technology Development and Assessment
Keywords: none
MeSH Terms: none

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