LAUSR

Study Objectives: Emergency departments (EDs) function as a safety net for vulnerable populations who lack reliable access to health care, including those who face housing insecurity and who lack or possess limited insurance These groups commonly utilize emergency care for low acuity conditions including asthma, pneumonia, cellulitis, and urinary tract infections, which can be treated with short courses of steroids or antibiotics, respectively However, vulnerable patients face multiple barriers to filling prescriptions including cost, transportation and wait times at the pharmacy Providing these patients with full courses of pre-packaged medications has the potential to improve medication compliance and health outcomes The COVID-19 pandemic has created unique challenges for discharging patients with low acuity conditions from the ED Not only have vulnerable and disadvantaged populations been affected disproportionately by COVID-19, but also, barriers to filling prescriptions are now compounded by pharmacy closures and social distancing In the face of increased demand for medications used to treat respiratory disease and infection, the goal of this work was to examine a potential solution to enhancing patients’ access to medications during the COVID-19 pandemic Methods: In a large urban academic hospital in Boston, a “to-go” medication program was used for patients discharged from the ED during the local surge of the COVID-19 pandemic (March 2020 - April 2020) Patients diagnosed with asthma, cellulitis, COPD, pneumonia, or urinary tract infection who did not require hospitalization received pre-packaged to-go medications free of charge prior to discharge A monthly report was generated for each to-go medication through the electronic medical record Retrospective chart review was conducted to obtain de-identified demographic information for those patients Microsoft Excel was used to generate descriptive statistics This study was approved by the Institutional Review Board of Partners Healthcare, Boston Results: A total of 50 patients from March 13 - April 30, 2020 were discharged with to-go medications Demographics are listed in Table 1 During the surge of the COVID-19 pandemic at our institution, 66% of patients who received to-go medications were diagnosed with a respiratory illness Of the patients in the to-go medications program, 56% did not have private insurance, 26% did not speak English as their primary language, and 30% were undomiciled Conclusion: The "to-go" medications program has the potential to improve medication adherence while also reducing infection transmission by promoting social distancing through avoiding pharmacy visits In future research, we aim to continue to analyze the effects of this program on vulnerable populations in order to improve equitable access to health care for all as well as to study how this program affects ED return visits and by extension overall hospital costs [Formula presented]