Association Between Onsite Outpatient Pharmacy Availability, Medication Fill Rates, and Readmissions in Mental Health Hospitals

Background: Medication non-adherence is common among patients with serious psychiatric disorders and is associated with relapses, adverse outcomes, and rehospitalization. Discharging patients with medications in hand may improve adherence and reduce readmission rates, yet few studies have examined the role of onsite discharge pharmacies in inpatient psychiatric settings. Objective: This study aims to compare discharge medication fill rates and 30-day readmission rates between two inpatient psychiatric hospitals in the same health system, one with an onsite outpatient pharmacy (MV) and one without (DV). Materials and methods: This retrospective chart review included 565 adult patients discharged over a three-month period. Data collected included demographics, psychiatric diagnoses, discharge medications, prescription types (MV, e-prescription, and printed), and 30-day readmission rates. Filled discharge medications were verified via MV, e-prescriptions, payor pharmacy claims, or contact with external pharmacies. Statistical analyses used chi-square tests; p < 0.05 was considered significant. Results: Patients discharged from MV had higher overall prescription-filling rates (265, 88.6%) than those discharged from DV (148, 54.8%) (p < 0.001). Full prescription fill rates were 212 (82.2%) for scripts sent to MV, 64 (77.1%) for e-scripts, and 81 (35.5%) for printed scripts. Thirty-day readmission rates were lower at MV (22, 7.4%) versus DV (32, 11.6%), though this difference did not reach statistical significance (p = 0.075). The verification revealed that the insurance claims data was only 46% accurate, highlighting the importance of direct verification. Conclusions: Patients discharged from MV with medication in hand had significantly higher medication fill rates and significantly lower readmission rates than those discharged with e-prescriptions or printed prescriptions. This finding contributes to a growing body of research indicating that discharging patients with medication in hand is an effective strategy for increasing medication adherence and reducing rehospitalization.