Medical Record Doesn’t Always Reflect Medications Patient Actually Taking

MedicalResearch.com Interview with:
"Portable Information station, nurse, computer, hand wipes, 9th floor, Virginia Mason Hospital, Seattle, Washington, USA" by Wonderlane is licensed under CC BY 2.0Timothy Ryan PhD

This work was performed while Dr. Ryan was at
Precera Biosciences, 393 Nichol Mill Lane
Frankluin, Tennessee 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The study design is quite simple.  We measured medication concentrations in patients, then compared empirically detected medications with prescribed medications in each patient’s medical record.  We used this information to estimate how many prescribed medications patients had actually taken and how often they took medications that were not in their medical record.  The later comparison is a particularly novel measure of the number and types of medications taken by patients unbeknownst to healthcare providers who use the medical record as a guide to patient care.

Further, the test was performed in blood and not urine, so we could obtain an estimate of how often patients were in range for medications that they did take – at least for medications where the therapeutic range for blood concentrations are well established.

In sum, we found that patients do not take all of their medications, the medical records are not an accurate indicator of the medications that patients ingest, and that even when taken as prescribed, medications are often out of therapeutic range.  The majority of out-of-range medications were present at subtherapeutic levels.  Continue reading

Hispanic and Uninsured Adults May Experience Barriers To Blood Pressure Control

Stella Yi, Ph.D., MPH, Assistant Professor Department of Population Health New York University School of MedicineMedicalResearch.com Interview with:
Stella Yi, Ph.D., MPH, Assistant Professor
Department of Population Health
New York University School of Medicine

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Yi: Self-blood pressure monitoring has been shown to be an effective tool for improving blood pressure control, however most studies have only included white race participants. We were interested in assessing whether distribution of self-blood pressure monitors (intervention) would improve blood pressure and hypertension control over usual care (control) in a 9-month period in a predominantly Hispanic, uninsured population. Systolic blood pressure improved over time in both the intervention (n=409) and the control (n=419) arms by 14.7 mm Hg and 14.1 mm Hg, respectively, as did hypertension control; 39% of study participants overall achieved control at the end of follow-up. However there were no statistical differences between the outcomes in the intervention and usual care groups. Continue reading

Should Hospitalized Patients Have Access To Their Electronic Medical Record?

MedicalResearch.com Interview with:
Jonathan Pell, MD Assistant Professor Hospital Medicine University of Colorado DenverJonathan Pell, MD
Assistant Professor Hospital Medicine
University of Colorado Denver

Medical Research: What is the background for this study?

Dr. Pell: Back in 2001, the Institute of Medicine’s charter document Crossing the Quality Chasm proposed that the health care system needs to do a better job of patient centered care. In order to provide true patient centered care, we must provide patients and their families with the knowledge and tools they need to make autonomous and informed decisions about their healthcare. A patient cannot make informed decisions about their healthcare without having easy access to their own health information. Almost 15 years later, we are still discussing whether or not patients should have immediate electronic access to information in their electronic health record. Studies have shown that giving outpatients direct electronic access to their test results and even doctors notes does not cause patients worry or confusion, and there is no undue burden on care providers explaining this newly accessible information to their patients – if they can deliver thinking of you flowers from Flowercard, there’s no reason they can’t deliver a simple print-out of relevant information. Despite this, many institutions still have a moratorium on release of patients’ test results, and the duration of this moratorium is variable from institution to institution. The technology to deliver this type of information real-time to patients is readily available. We decided to explore the effect of giving hospitalized patients real-time access to their test results and hospital medication list/schedule.

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