1. Hospitalization rate among chronically ill low vision patients using a home prescription label reader vs. a pill box. Bruce I. Gaynes, OD, PharmD 1,2, Tatyana Spektor MD 3, Nicole Nicolic, BS 1 1.Loyola University Chicago, Stritch School of Medicine, Department of Ophthalmology, Maywood, IL 2. Edward Hines Jr. VA Medical Center, Hines IL 3. Rush University Medical Center, Department of Ophthalmology, Chicago, IL Introduction Methods Figure 3. Annual hospitalization rate and total hospitalizations per patient Overall, 57 patients (67.9%) reported regular use of a pillbox, 21 (25%) patients denied pillbox use. With respect to use of other assistive devices aside from ST or a pill box, 54.8% reported use of at least 1 other device, the most common being a hand held magnifier. Of the subjects using pillboxes, 61.4% filled them independently, 38.6% required the assistance of another person. Of the multivariate predictors of repeat hospital admission, including: age, degree and duration of vision loss, and whether or not the subject was reminded to take their medication, the degree of vision loss was the strongest risk factor for increased number of hospital admissions. The rate of hospitalization by vision loss is shown in Figure 2. The influence of pill box use on annual hospitalization rate and total per patient hospitalization is shown in Figure 3. At the conclusion of the study interval 2 of the 84 subjects had expired and only 13% of the cohort continued to order medications with ST enabled Rx labels. Methods Participants were identified as being high-risk patients if it was deemed their medication regimen and comorbidities posed a significant hazard in the event of medication mis-adventure. The criteria used to determine this risk included: having at least 1 prescribed medication with a low therapeutic index, being treated for congestive heart failure, taking greater than 4 anti-hypertensive medications and/ or having multiple significant risk factors for cardiovascular disease. Prescription medications with a low therapeutic index included warfarin, anti-epileptics, and anti- arrhythmic medications. The presence of insulin-dependent diabetes mellitus, coronary artery disease and/or having a history of previous myocardial infarction or cerebral vascular accident were considered to be significant comorbidities. Whether or not a patient missed medication administration was determined by self-reporting. Causes for visual impairment are shown in Figure 1 below: A retrospective cohort study was performed examining high-risk chronically ill patients enrolled into the ScripTalk® program from 2006-2011 at the Hines Veterans Affairs Hospital. The degree of visual impairment, co-morbidities, use of a pillbox, reported missed medications, and hospitalizations were selected co-variants for analyses. Study subjects were identified from the 864 patients at Hines Veterans Affairs Hospital who were enrolled into the ST program from 2006-2011 following discharge from the Hines VA Blind Rehabilitation Center. From this group, 84 patients were identified as being high-risk with multiple significant comorbidities. Age of the study cohort ranged from 49-97 years. With respect to modifiable risk factors, the use of a pillbox appears to be a relatively simple and effective addition to assist visual impaired patients in appropriate home medication use. The benefit of a prescription label reader in reducing hospitalization rate among individuals is less apparent in the constraints of the current study design. Conclusion 4160-A0148 Corresponding author: bgaynes@luc.edu Author disclosures: none The support of the Richard A Perritt Charitable Foundation is acknowledged ScripTalk® (ST) is a text-to-speech prescription medication label reader designed to help the visually impaired prevent medication administration errors in the home environment. Our study focuses on characterizing the users of ScripTalk®, highlighting risk factors for adverse events and addressing efficacy of the label reader technology vs. use of common pill-box organizers in terms of rate of hospitalization Figure 2. Hospitalization rate and visual function Figure 1.Causes of visual impairment Results