The Pillbox Format: Novel Use in Discharge Medication List

1Exempla Lutheran Medical Center, Wheatridge, CO
2CFMC, Englewood, CO

Meeting: Hospital Medicine 2011, May 10-13, Dallas, Texas.

Abstract number: 174

Background:

The transition from hospital to home is critical for patients, especially for those with a complicated medication regimen. Patients often report problems understanding and using the traditional medication discharge list. The authors created a pillbox medication discharge list that uses a pillbox format familiar to patients.

Purpose:

To decrease medication errors and increase understanding of the medication regimen for patients discharged from the hospital using the pillbox medication discharge list.

Description:

The team consisted of a hospitalist, care transition coach, and an office manager of a local primacy care office. Over an 8‐week period 19 patients were recruited. Eligible patients were those 70 years or older who used more than 5 different medications, lived independently, and were able to fill a pillbox themselves or had a caregiver to assist. On discharge the hospitalist provided both a traditional hospital medication reconciliation list and a pillbox medication discharge list (Table 1). The pillbox list was handwritten in 16‐point type. After discharge, the office manager or the care transitions coach conducted a brief telephone survey with the patient. The survey consisted of 7 questions that assessed the patient's ease of understanding of the traditional discharge medication list, how the 2 medication lists compared in ease of understanding and use, how confident the patient felt about following the instructions on the pillbox medication list, how often he or she used the pillbox medication list, if fewer medication mistakes were made, and if he or she would use the pillbox medication list in the future. Answers were ranked on a scale to which numeric values were assigned, with “strongly agree and always” = 1, ‘agree and usually” = 2, undecided and half of the time” = 3, “disagree and seldom” = 4, and “strongly disagree and never” = 5. Values 1 and 2 are rated as positive, value 3 as neutral, and values 4 and 5 as negative. Of the 14 respondents who completed the survey for all 7 questions, 72.4% had an overall positive perception, 6.1% a neutral perception, and 4% a negative perception of a pillbox‐formatted medication list. A majority of the respondents had a favorable response about the pillbox‐formatted medication list regarding use and ease of understanding (Table 2). Fewer medication errors were made using the pillbox‐formatted medication list; in fact, 93% of respondents had a favorable response, whereas none had a negative or neutral response. Finally, all respondents would use the pillbox list in the future.

Table 1.

Table 2.

Conclusions:

Patients prefer a medication list written in a pillbox format and indicate this pillbox medication list may be easier to understand and use with less self‐reported medication errors. This low‐tech intervention, which aimed to reduce medication errors, especially after discharge, is perhaps a cost‐effective intervention for various inpatient settings, including smaller community or rural hospitals. Dedicated to Lt. Colonel Levi E. Butler, USAF Ret., and our parents.

Disclosures:

K. Hoekstra ‐ none; H. Amthauer ‐ CFMC, employment

To cite this abstract:

Hoekstra K, Amthauer H. The Pillbox Format: Novel Use in Discharge Medication List. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 174. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/the-pillbox-format-novel-use-in-discharge-medication-list/. Accessed April 1, 2020.

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