Preop Medication Compliance Better With Instruction Combo

Preoperative medication compliance improved when patients were given a simple, standardized, multicolored medication instruction sheet combined with verbal instructions, according to an article published in the July issue of Anesthesiology.

Failure to remember and comply with instructions can result in rescheduled same-day surgeries and longer hospital stays. Patients in the study were scheduled for general surgery, gynecology, otolaryngology, neurosurgery, thoracic/vascular surgery, cardiac surgery, urology, plastic surgery, or orthopedic surgery.

Lead author Thomas Vetter, MD, MPH, from the Department of Anesthesiology, School of Medicine, University of Alabama at Birmingham, and colleagues compared behaviors of 519 surgical patients in a control group who were given traditional preoperative medication instructions (annotated or highlighted portions of the patient’s electronic medical record, or verbal instructions) with behaviors of 531 patients who got the instruction sheet combined with verbal reinforcement.

The sheet listed all the medications the patients needed to take on the day of surgery, those they should not take (blood thinners, for example), and those that could be taken as needed. Next to the categories were brightly colored go, stop, and yield signs, respectively.

Researchers found that 74% of those who received the instruction sheet were compliant with their medication instructions on the day of surgery vs 60% in the control group. Patients who got the sheet were also less likely to stay in the Post-Anesthesia Care Unit for more than 90 minutes (46%; 95% confidence interval, 42% – 50%) than those in the control group (54%; 95% CI, 50% – 59%; P = .011).

The findings are important because of the volume of information physicians and nurse practitioners must convey to patients before surgery. Authors cite estimates that 40% to 80% of medical information that healthcare practitioners provide to patients is forgotten immediately, and nearly half of such medical information the patient recalls is incorrect.

A standardized sheet can help patients undergoing any type of surgery sort out instructions, the authors conclude.

“Certain long-term medications should be continued on the day of surgery, and some should be temporarily stopped, but there is no consistency in how patients receive medication instructions before surgery,” Dr. Vetter said in a news release. “Our effort to enhance patients’ understanding of medication use before surgery is important and can increase patient satisfaction by more actively engaging them in their own health care.”