Point of Care Automated Medication Delivery System
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University of Miami
South Florida
Diabetes and Cardiovascular Disease Risk Factors
Primary care clinics
African Americans, Latinos |
PROJECT
Patients receive diabetes medication at their doctor’s office, utilizing an automated medication delivery system.
An automated medication-delivery system allows physicians to fulfill prescriptions for diabetes, blood pressure or cholesterol medicines at the time of the clinic visit. Based on prescriptions entered into electronic medical records, a controlled-access storage cabinet in the clinic office automatically dispenses pre-packaged medications, which are delivered to the patient during their appointment. A four-step quality control protocol, including color-coded labels, ensures that the correct patient receives the proper medication. Containers are labeled with the patient’s name, and patients are provided with a printed summary of the prescription, including instructions and a picture of the pills themselves. The summary can be provided in English or Spanish.
RATIONALE
Medication adherence is a key component in diabetes management, but many patients fall short of adherence targets. This point of care medication delivery system helps overcome various barriers to obtaining medications and maintaining medication adherence. These barriers include difficulties in the patient’s environment such as transportation to the pharmacy, neighborhood safety, or time constraints. By changing the place where a patient receives his medication (from pharmacy to clinic), this intervention restructures the way a patient receives care.
The medication delivery system links the clinical encounter to the medication-filling process, which has the potential to make adherence issues a central part of the physician-patient interaction. Physicians may gain a deeper understanding of the challenges of the prescribed regimen, and patient barriers to adherence. Patients, in turn, may be able to learn more about the regimen and discuss concerns about the medication during the clinic visit itself. The link between the automated
medication-delivery system and the patient’s electronic medical record gives physicians better information about that patient’s adherence.
EVALUATION PLAN
Funded by Finding Answers in 2010.
Researchers are using a pre-post experimental design to examine the impact of the intervention on patients’ medication adherence, glycemic control, cholesterol and blood pressure. Patient medication adherence and clinical outcomes are being examined for the 12 months prior to and the 12 following the first use of the automated medical delivery system. Researchers are examining medication adherence and clinical outcomes of African American and Hispanic patients, and also comparing their results to those of White patients.
Qualitative research methods are being used to explore the challenges to and facilitators of the implementation process. Researchers are also examining historical claims data, pharmacy costs and dispensing statistics to extrapolate future cost savings.
Principal Investigators:
- Ana M. Palacio, MD, MPH (Assistant Professor, University of Miami)
- Olveen Carrasquillo, MD, MPH (Chief, Division of General Medicine, University of Miami)
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