Key result
An in-home clinical pharmacist transition of care program did not significantly reduce 30-day readmission rates, ED visits, or outpatient visits compared to the control group (p > 0.05).
Why the study?
Does an in-home clinical pharmacist's transition of care program reduce 30-day readmissions and urgent care use in recently discharged Medicare Advantage patients?
Cohort (n=245)
Does an in-home clinical pharmacist's transition of care program reduce 30-day readmissions and urgent care use in recently discharged Medicare Advantage patients?
p-value: p=> 0.05
An in-home clinical pharmacist transition of care program did not significantly reduce 30-day readmissions or urgent healthcare use in Medicare Advantage beneficiaries, though it was well-accepted by patients.
RATIONALE, AIMS & OBJECTIVES: A variety of transition of care interventions has been evaluated to date to reduce readmissions. No studies evaluated effectiveness of clinical pharmacist's home-visits to recently discharged Medicare Advantage patients with the goal of preventing subsequent readmissions and urgent care use. The objective of this study was to evaluate the effectiveness of in-home clinical pharmacist's transition of care program on 30-day all-cause readmissions, emergency department (ED) visits, outpatient visits, as well as to assess patient satisfaction with the program. METHODS: The study used retrospective cohort design. RESULTS: A total of 245 patients were included in the study (mean (SD) age 77.8 (8.7); mean Charlson's Comorbidity Index 5.0 (2.5); 53.5% male). Forty-seven patients (19.0%) experienced at least one ED visit and twenty-two patients (9.0%) were readmitted within 30 days. The two groups did not differ on available demographic and clinical characteristics (p > 0.05). There was no difference in 30-day readmission rates, percent of patients with ≥1 ED visit, ≥1 outpatient physician office visit between the groups (p > 0.05). A total of 78 program participants responded to a satisfaction survey with 95% agreeing the program helped to stay healthy at home. CONCLUSION: Multiple medication-related problems were identified by in-home pharmacists and the program appeared to be well-accepted by participants. In this study we did not find that the program had an impact on reduction of inpatient or urgent healthcare use. Further research using a different study design and a larger sample to estimate the program effectiveness is warranted.
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Shcherbakova et al. (2015) conducted a cohort in Recently discharged Medicare Advantage patients (n=245). In-home clinical pharmacist's transition of care program vs. Standard care / No in-home pharmacist visit was evaluated on 30-day all-cause readmissions, emergency department (ED) visits, and outpatient visits (p=> 0.05). An in-home clinical pharmacist transition of care program did not significantly reduce 30-day readmission rates, ED visits, or outpatient visits compared to the control group (p > 0.05).
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