May 14, 2007
Heart-failure patients take their medicine more reliably when under the care of a pharmacist, resulting in fewer emergency-room visits and hospital stays and lower health-care costs, according to a study led by Michael D. Murray, PhD, the Mescal S. Ferguson Distinguished Professor at the School.
According to the American Heart Association, more than five million people in the United States are in various stages of heart failure with total health-care costs exceeding $29 billion. The study, published in the June 2007 issue of the Annals of Internal Medicine, studied 314 low-income patients with heart failure. The participants were studied as two groups: One group received typical services from a pharmacist, and the other received care from a specially trained pharmacist who had access to customized educational materials, provided comprehensive instruction to participants, and reminded them to refill their prescriptions.
The study not only improved the way patients took their pills and reduced the rate at which their heart failure worsened, it also had impressive cost savings. “For every one dollar we spent on the intervention group, the health-care system gained fourteen dollars in savings by decreasing emergency-room visits and hospitalization,” Murray said.
Compared to patients in the control group, those who received special intervention:
• took their medications 16 percent more consistently,
• visited the emergency room and were hospitalized 19 percent less, and
• had direct annual health-care costs nearly $3,000 lower per patient.
“The key to the success of our intervention was taking time with patients to create a regular schedule for taking their medicines that fit their lifestyle,” said James Young, the intervention pharmacist involved in the study.
“We made sure that patients understood how their medications worked and why taking them consistently was so important,” said Young, a research pharmacist with Wishard Health Services in Indianapolis and a coauthor of the study.
The study investigators created special materials designed to help patients with lower levels of health literacy. For example, patients taking an ACE inhibitor received their pills in a bottle marked with an ace-of-hearts sticker. A corresponding information sheet, designed to be easier to read and understand, was also marked with the ace of hearts.
The study was funded by the National Institutes of Health.
Other authors of the study are:
- Wanzhu Tu, PhD; Michael Weiner, MD, MPH; Jingwei Wu, MS; Daniel Clark, PhD; and Faye Smith, MAS, of the Indiana University School of Medicine’s Regenstrief Institute
- Daniel Morrow, PhD, the University of Illinois
- Kevin T. Stroupe, PhD, Hines Veterans Affairs Hospital, Hines, Illinois
- Irmina Gradus-Pizlo, MD, and D. Craig Brater, MD, Indiana University School of Medicine
- Morris Weinberger, UNC School of Public Health
- Shawn Hoke, Roudebush Veterans Affairs Medical Center, Indianapolis
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