VNSNY Nurse Nana Asamoah: Managing Patients’ Medications During the Pandemic—and Beyond

Even before the COVID-19 pandemic, medication management was a struggle for many people. Research shows that nearly 3 out 4 Americans don’t take their medications as directed in the best of times, and 1 in 3 never even bother to fill their prescriptions.

The complications of COVID-19 have made this bad situation even worse: Many pharmacies and doctor’s offices were closed for a time, and even today many still have reduced hours or are difficult to reach, with limited deliveries. At the same time, people are quarantined at home and unwilling to go out, and family members and other caregivers are staying away because of social distancing. On top of that, many patients have new medication regimens to treat the coronavirus itself.

As a nurse with VNSNY Home Care’s Manhattan Branch 6, Nana Asamoah sees such scenarios on a regular basis. When she reconciles a new patient’s medications as part of her initial assessment after they’ve been discharged from the hospital, the patient will often hand Nana many duplicates of the same medication. “That’s a red flag that they are not taking their medications,” she explains, adding that the reasons for this failure can vary. “Maybe they have arthritis and can’t open the bottle. Maybe they are forgetful. Maybe a family member who says they are the caregiver is not really participating.”

This is where Nana steps in to help. She provides extensive education to both the patient and the caregiver, to set them on the right course and help ensure that as they recover, they can follow the patient’s medication regimen exactly as the doctor has ordered. One strategy Nana uses is to connect interested patients who are at risk for not taking their medications properly with VNSNY’s medication management partner, ExactCare.

When a patient is enrolled in ExactCare, they receive their medications in pre-poured amounts, sealed in easy-to-open packages that are clearly marked for the day and time they need to be taken. The packages are sent to each patient at home, minimizing risk of exposure to COVID-19. ExactCare also strives to obtain all prescriptions for a given patient to ensure an accurate and complete medication profile. Their staff will then connect with the patient’s doctors and pharmacies as needed to streamline medications and guard against drug interactions.

All of this goes a long way to restoring independence for recovering patients and keeping their recovery on track, thereby preventing return trips to the hospital. Nana recalls one patient who had just been discharged from the hospital with congestive heart failure. In Nana’s initial assessment, the patient showed her five bottles of the same diuretic. “I knew she would end up right back in the hospital if she didn’t get her medications managed,” says Nana. “So as part of her care plan, I connected her with ExactCare. Immediately she was less stressed and very happy to have the service in place. We also provided her with a Spanish translator, and that helped, too.”

Recently, Nana helped another patient with end-stage cancer who was just released from the hospital with COVID-19 and was staying at her daughter’s house outside the city. “Unlike many of our patients, this patient was not on a lot of medications, but her daughter has little kids—so getting her mother on a medication management program with ExactCare meant she had one less thing to worry about,” says Nana—noting that since then, the plan has helped the patient avoid hospital readmission.

During the height of the pandemic, the personalized medication management service that Nana and ExactCare were able to offer her patients, became especially important. “I feel like I’m part of the VNSNY team and their mission to care for patients during this tough time,” says Horacio Fernandez, an ExactCare Clinical Account Manager. “Their dedication to their patients is one of the main reasons I love working with clinicians like Nana. I think every day about VNSNY’s clinicians and their safety out there in the field. ExactCare and I are here with support, not only when patients are receiving VNSNY care at home but also afterwards, to ensure that they can safely and independently manage their medications after their episode of care is completed.”

For all the ease of ExactCare’s medication management program, it has still required courageous persistence on the part of Nana and her clinical colleagues to visit and assess patients during the COVID-19 pandemic. In describing the many steps involved in carefully donning and doffing PPE before and after such visits, one step stands out for Nana: “I would call my family when I was coming home, and my seven-year-old would meet me at the door with a garbage bag,” she recounts. “I’d take off my clothes and put them in the bag, tie it up, and then walk straight into the shower.”

Like so many VNSNY clinicians on the front lines and behind the scenes, Nana might never think of herself as a “hero,” but her dedication to helping patients recover their health and their strength—and connecting them with the means to stay strong in the face of whatever is next to come—is evidence of the heroic work she does every day. As Nana says, “We all do what we need to do.”