title: Predictors of patient medication compliance on the day of surgery and the effects of providing patients with standardized yet simplified medication instructions.
abstract: BACKGROUND
  Anesthesiologists are responsible for optimizing patients' preoperative medications, including maximizing their compliance with preoperative medication instructions. The authors hypothesized that a standardized, simplified instruction sheet presented and verbally reinforced during the preanesthesia clinic visit would improve patient medication compliance on the day of surgery.
  
  
  METHODS
  An unmatched case-control design was applied, with nonrandomized, preintervention (controls) and postintervention (cases) data collected. In the preintervention group, patient education/instruction regarding taking medications on the day of surgery continued in the existing, unstandardized manner. In the postintervention group, patients were given a simplified, multicolored Preoperative Patient Medication Instruction Sheet, which was consistently verbally reviewed with patients. Group differences and independent variable associations were analyzed with conventional inferential biostatistics.
  
  
  RESULTS
  A total of 521 and 531 patients were enrolled in the preintervention group and postintervention group, respectively. Of this, 309 patients (60%) of preintervention group versus 391 patients (74%) of postintervention group (P < 0.001) were compliant with their preoperative medication instructions on the day of surgery. Use of the Preoperative Medication Instruction Sheet (adjusted odds ratio [aOR] = 1.83; P < 0.001), Caucasian race (aOR = 1.74; P = 0.007), and recalling receiving both verbal/written preoperative medication instructions (aOR = 1.51; P = 0.006) were associated with greater patient medication compliance. Older age (aOR = 0.67; P = 0.014) and higher American Society of Anesthesiologists status (aOR = 0.60; P = 0.004) were associated with lesser patient medication compliance.
  
  
  CONCLUSIONS
  A standardized, multicolored, pictorial Preoperative Patient Medication Instruction Sheet, with patient communication in both verbal/written forms, seems to improve patient medication compliance on the day of surgery. African-Americans, older patients, and those with greater comorbidities may require a more concerted effort to achieve an adequate preoperative medication compliance.
authors: From the Department of Anesthesiology (T.R.V., M.E.D., A.M.B.), Department of Emergency Medicine (S.C.V.), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and Department of Nursing and the Center for Nursing Excellence (K.M.N.), University of Alabama at Birmingham Hospital, Birmingham, Alabama.
authors: Thomas R
authors: TR
authors: Vetter
authors: Michelle E
authors: ME
authors: Downing
authors: Sean C
authors: SC
authors: Vanlandingham
authors: Kristen M
authors: KM
authors: Noles
authors: Arthur M
authors: AM
authors: Boudreaux
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000758:Anesthesia; D016022:Case-Control Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016017:Odds Ratio; D010045:Outpatients; D010353:Patient Education as Topic; D011237:Predictive Value of Tests; D012959:Socioeconomic Factors