follow up. detail lacking on the actual components of the calls and home visits. Telehealth Source and type of evidence 1. Definitions 4. Population Group and Size 8. Outcomes assessed and 10. Resource Implications 13. Key conclusions 5. Health Condition / effects on outcomes 11. Enablers 14. Recommendations for Country Problem 9. Components associated 12. Barriers Practice, Policy, Education, 2. Overview of Models 6. Healthcare context / with improved outcomes Research setting addressed Aim 3. Main components 7. Nursing disciplines involved Telephone support Fischer et al (2015). 1. NR. 4. Patients identified as 8. Primary outcome was 10. NR 13. Nurse reminder calls US. PMN (primary medication pick up of prescription for patients who were 2. Nurse reminder to non-adherent) i.e. who had within 30 days. 25% of 11. NR. primary medication RCT. patient to pick up not collected their newly intervention patients and for newly medicines not collected at prescribed medicines after 24% of control patients 12. Delay before contact by prescribed medicines for To evaluate the ability of an the pharmacy. 14 days and three picked up their nurses initiated was certain chronic diseases did additional nurse directed automated and one live call prescriptions within 30 identified as a possible not prove to be effective. telephone intervention to 3. Up to three attempts from the pharmacy days. Difference non factor in apparent reduce primary medication over 2 days to call the (n=290). significant Multivariate ineffectiveness of 14. More research needed non-adherence. patient on the phone at analysis OR 1.08 (95% CI intervention. Low level of on current rate of primary different times of day. 5. Patients who were on 0.62-1.89, p=0.79). primary medication medication non-adherence Message left on patient’s medicines for (6% - much (which may have changed phone if not contacted. hypertension, 9. Anti-hypertensives lower than found in from when first hyperlipidaemia, asthma showed the highest rate of previous studies) was also researched). Intervention and type 2 diabetes. pick up (47%), a factor in the lack of may need to be changed to hyperlipidaeamia meds effectiveness of the include re-engagement 6. Geisinger Health System lowest (5.3%). intervention with the primary care – network of over 40 provider who prescribed community based clinics in the medicine. Pennsylvania.
follow up. detail lacking on the actual components of the calls and home visits. Telehealth Source and type of evidence Country Aim 1. Definitions 2. Overview of Models 3. Main components 4. Population Group and Size 5. Health Condition / Problem 6. Healthcare context / setting addressed 7. Nursing disciplines involved 8. Outcomes assessed and effects on outcomes 9. Components associated with improved outcomes 10. Resource Implications 11. Enablers 12. Barriers 13. Key conclusions 14. Recommendations for Practice, Policy, Education, Research Telephone support Fischer et al (2015). US. RCT. To evaluate the ability of an additional nurse directed telephone intervention to reduce primary medication non-adherence. 1. NR. 2. Nurse reminder to patient to pick up medicines not collected at the pharmacy. 3. Up to three attempts over 2 days to call the patient on the phone at different times of day. Message left on patient’s phone if not contacted. 4. Patients identified as PMN (primary medication non-adherent) i.e. who had not collected their newly prescribed medicines after 14 days and three automated and one live call from the pharmacy (n=290). 5. Patients who were on medicines for hypertension, hyperlipidaemia, asthma and type 2 diabetes. 6. Geisinger Health System – network of over 40 community based clinics in Pennsylvania. 8. Primary outcome was pick up of prescription within 30 days. 25% of intervention patients and 24% of control patients picked up their prescriptions within 30 days. Difference non significant Multivariate analysis OR 1.08 (95% CI 0.62-1.89, p=0.79). 9. Anti-hypertensives showed the highest rate of pick up (47%), hyperlipidaeamia meds lowest (5.3%). 10. NR 11. NR. 12. Delay before contact by nurses initiated was identified as a possible factor in apparent ineffectiveness of intervention. Low level of primary medication (6% - much lower than found in previous studies) was also a factor in the lack of effectiveness of the intervention 13. Nurse reminder calls for patients who were primary medication for newly prescribed medicines for certain chronic diseases did not prove to be effective. 14. More research needed on current rate of primary medication non-adherence (which may have changed from when first researched). Intervention may need to be changed to include re-engagement with the primary care provider who prescribed the medicine.
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