Comparison of Telephone and In-Person Preoperative Evaluations on Patient Morning of Surgery Medication Compliance

Abstract

Background Patient medication compliance is a common challenge across all medical specialties. Prior studies in anesthesia demonstrate compliance increases with multimodal interventions including standardized EMR generated instructions. However, transitioning from in-person to virtual modalities may narrow the available of interventions patients receive thereby impacting medication compliance. Preoperative telemedicine encounters are associated with high patient satisfaction and cost savings but the effectiveness of preoperative telephone encounters and compliance with medication instructions on the morning of surgery has not been studied at length. Methods In this prospective cohort study, anesthesia clinic providers in an academic medical center gave morning of surgery medication (MoSM) instructions during a preoperative anesthetic evaluation, either in-person or via telephone. On the day of surgery, an original questionnaire was administered comparing each patient’s verbal report of their MoSM taken to a record of their MoSM instructions. The percent of compliance for medications taken was calculated and patients who achieved 100% were considered compliant. Questionnaire data was analyzed using Cohort statistics. Results Compliance with MoSM taken were 46% and 54% in the in-person and telephone cohorts, respectively. There was no statistically significant association between the compliance and encounter type. (p=0.4681) In the general sample population, those who were 55 or older (RR=1.5085; p=0.0401) or on three or more MoS medications (RR=2.0167; p=0.0001) were associated with a higher likelihood to be non-compliant. There was a statistically significant association between compliance and age among patients younger than 55 years old and patients 55 years old and older (p=0.0431) as well as between compliance and the number of MoSM to take among patients with less than three medications and patients with three or more medications. (p=0.0001) Conclusion These findings suggest that implementation of telephone evaluations at an academic medical center achieved a similar level of compliance to in-person visits despite reductions in patient interventions received. However, factors such as older age and high numbers of MoSM may increase the likelihood of patient non-compliance and identify which patients providers should target efforts to achieve greater compliance.