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.
Key words
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Biography
Deonni P. Stolldorf is Assistant Professor, Vanderbilt University School of Nursing, Nashville, TN. Twitter: @research_dee. ORCID identifier: https://orcid.org/0000-0002-1352-5397.
Biography
Abby B. Jones is Research Assistant, Vanderbilt University School of Nursing, Nashville, TN. ORCID identifier: https://orcid.org/0000-0002-6934-7593.
Biography
Karen F. Miller is Senior Associate, Center for Emergency Care Research and Innovation, Vanderbilt University Medical Center, Nashville, TN. ORCID identifier: https://orcid.org/0000-0003-3474-3390.
Biography
Hadassah H. Paz is Clinical Translational Research Coordinator III, Vanderbilt University Medical Center, Nashville, TN. ORCID identifier: https://orcid.org/0000-0001-5390-0393.
Biography
Bryn E. Mumma is Associate Professor, University of California, Davis School of Medicine, Sacramento, CA. Twitter: @mummabem. ORCID identifier: https://orcid.org/0000-0002-2900-2048.
Biography
Valerie C. Danesh is Research Scientist, Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX. Twitter: @DaneshVC. ORCID identifier: https://orcid.org/0000-0002-2078-2578.
Biography
Sean P. Collins is Professor of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN. ORCID identifier: https://orcid.org/0000-0002-2305-9836.
Biography
Mary S. Dietrich is Professor, Statistics and Measurement, Vanderbilt University School of Medicine, Vanderbilt University School of Nursing, Nashville, TN. ORCID identifier: https://orcid.org/0000-0003-4474-0767.
Biography
Alan B. Storrow is Associate Professor and Associate Director for Research, Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN. ORCID identifier: https://orcid.org/0000-0002-2893-808X.
Article info
Publication history
Published online: January 07, 2023
Identification
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© 2022 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
