Info packets don't help people take ER meds

In a test of services geared toward making sure patients took their prescribed medications after leaving the emergency room, none made a difference, a large new study suggests.

Based on the experiment involving nearly 4,000 ER patients, researchers found that information packets, personal assistance and even access to an on-call medical librarian to answer questions about the drugs did not lead patients to fill more prescriptions or to take them as directed when they left the hospital.

There is a great deal of evidence that patients who don't follow medication regimens have worse health outcomes and end up spending more for healthcare in the long run, according to the study's lead author Dr. Melissa McCarthy, who researches health policy and emergency medicine at George Washington University in Washington, D.C.

The National Library of Medicine created Medline Plus, an online drug information database, to encourage people to take medications as directed, but its effectiveness hadn't been measured, McCarthy said.

"We wanted these ‘information prescriptions' tested and evaluated, if people were given more information about their drugs are they more likely to take them?" she told Reuters Health.

McCarthy and her colleagues selected 3,940 people leaving three emergency rooms with prescriptions for antibiotics or for medications to treat respiratory, cardiac, gastrointestinal or nervous system distress (the drugs most commonly prescribed in emergency rooms) and divided the patients into four groups.

One group went through normal hospital procedures, another received practical assistance with filling the prescription if requested, the third got MedlinePlus prescription information online and in printed form and the fourth got both practical assistance and prescription information.

For practical assistance, participants were directed to a convenient pharmacy, informed of prescription discount services if cost was a concern, and given help getting to the pharmacy if needed.

The information group got detailed documentation on why the medicine was prescribed, its benefits and side effects.

The combination group had access to both forms of assistance as well as the phone number of a medical librarian to answer additional questions.

One week after ER discharge, 88 percent of patients had filled their prescription, according to pharmacy records, and in a phone interview 48 percent reported taking the medication as prescribed. Those percentages did not differ between the participating groups, according to results in the Annals of Emergency Medicine.

"The whole idea was to make this more patient centered, make it easier, make the process better, and I don't think it worked," McCarthy said.

According to Dr. Benjamin Sun of Oregon Health and Science University in Portland, who was not involved in the study, one reason the ‘information prescription' didn't work might be because ER doctors don't have long-term relationships with their patients, which would help them reinforce the need to take medication.