Emergency Department Pharmacy- Led MedicAtion Instruction (ExPLAIN): a pilot study

Ms C.J. Cabilan1, Dr Mary Boyde1,2,3, Ms Elizabeth Currey1
1Emergency Department, Princess Alexandra Hospital, Brisbane, Australia, 2School of Nursing, Midwifery, and Social Work, The University of Queensland, Brisbane, Australia, 3Nursing Practice Development Unit, Princess Alexandra Hospital, Brisbane, Australia

Background: A recent health service driven survey indicated that ¼ to ½ of patients discharged from the study Emergency Department (ED) believed they were not fully informed how to take new medications, the purpose of new medications, and medication side-effects. In response, a pharmacist-led intervention to provide medication counselling to patients who are discharged home from the ED with new medications was commenced.
Objectives: To compare satisfaction with information between patients who receive information from the pharmacist and usual care.
Methods: This is an on-going quasi-experimental study being conducted in a major ED in Brisbane, Australia. Patients discharged home with new medications were allocated to pharmacist or usual care using convenience sampling. The pharmacist-led intervention involved discussion and assessment of baseline knowledge of the new medication, medication dispensing, provision of verbal and written information, and assessment of comprehension using teach-back approach. Usual care was medication information mainly received from medical staff.   Demographics, health literacy and satisfaction with medication information were collected using validated tools. Inferential statistics were used to compare patient characteristics and satisfaction between patients. Statistical tests with a p value <0.05 were considered statistically significant.
Results: To date 51 patients had been recruited: 14 received intervention, 37 received usual care. Of the entire cohort, 90% had inadequate health literacy. There were no significant differences in age, sex, education, socio-economic status, and health literacy. Patients who received information from the pharmacist were significantly more satisfied with the information about their new medications compared to usual care patients (p<0.009). The intervention was associated with 18% improvement in patient satisfaction with medication information.
Conclusion: This pharmacist-led intervention in the ED was an effective strategy for improving patient satisfaction with medication information. Although the cohort had inadequate health literacy, the multimodal educational strategy with teach-back evaluation proved effective.

CJ Cabilan is a research nurse in the ED of the Princess Alexandra Hospital in Brisbane. She does not YET practice as an ED nurse; however she maintains a clinical position in acute care wards. As well, she teaches in the school of nursing in a major university in Brisbane. Her research interests are wide and this includes evidence-based nursing, systematic reviews, occupational violence, domestic violence, physical activity and exercise and quality of life in the cancer context.