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Observational Study
. 2023 Mar;49(2):275-286.
doi: 10.1016/j.jen.2022.12.002. Epub 2023 Jan 7.

Medication Discussions With Patients With Cardiovascular Disease in the Emergency Department: An Opportunity for Emergency Nurses to Engage Patients to Support Medication Reconciliation

Deonni P Stolldorf, Abby B Jones, Karen F Miller, Hadassah H Paz, Bryn E Mumma, Valerie C Danesh, Sean P Collins, Mary S Dietrich, Alan B Storrow
Observational Study

Medication Discussions With Patients With Cardiovascular Disease in the Emergency Department: An Opportunity for Emergency Nurses to Engage Patients to Support Medication Reconciliation

Deonni P Stolldorf et al. J Emerg Nurs. 2023 Mar.

Abstract

Introduction: This study aimed to investigate the level of patient involvement in medication reconciliation processes and factors associated with that involvement in patients with cardiovascular disease presenting to the emergency department.

Methods: An observational and cross-sectional design was used. Patients with cardiovascular disease presenting to the adult emergency department of an academic medical center completed a structured survey inclusive of patient demographics and measures related to the study concepts. Data abstracted from the electronic health record included the patient's medical history and emergency department visit data. Our multivariable model adjusted for age, gender, education, difficulty paying bills, health status, numeracy, health literacy, and medication knowledge and evaluated patient involvement in medication discussions as an outcome.

Results: Participants' (N = 93) median age was 59 years (interquartile range 51-67), 80.6% were white, 96.8% were not Hispanic, and 49.5% were married or living with a partner. Approximately 41% reported being employed and 36.9% reported an annual household income of <$25,000. Almost half (n = 44, 47.3%) reported difficulty paying monthly bills. Patients reported moderate medication knowledge (median 3.8, interquartile range 3.4-4.2) and perceived involvement in their care (41.8 [SD = 9.1]). After controlling for patient characteristics, only difficulty paying monthly bills (b = 0.36, P = .005) and medication knowledge (b = 0.30, P = .009) were associated with involvement in medication discussions.

Discussion: Some patients presenting to the emergency department demonstrated moderate medication knowledge and involvement in medication discussions, but more work is needed to engage patients.

Keywords: Cardiovascular; Emergency department; Medication; Medication reconciliation; Patient involvement.

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Figures

Figure 1:
Figure 1:
Proposed relationship between study variables
See this image and copyright information in PMC

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