A pharmacist-facilitated hospital discharge program did not significantly reduce 30-day readmission rates compared to control (22.1% vs 18%; P=0.17), despite resolving medication discrepancies.
Does a pharmacist-facilitated hospital discharge program reduce readmissions and emergency department visits in high-risk patients discharged to home?
A pharmacist-facilitated discharge program successfully reduced medication discrepancies but did not significantly impact 14-day or 30-day readmission rates or early emergency department visits.
Absolute Event Rate: 22.1% vs 18%
p-value: p=.17
BACKGROUND: Medication discrepancies are common at hospital discharge and can result in adverse events, hospital readmissions, and emergency department visits. Our objectives were to characterize medication discrepancies at hospital discharge and test the effects of a pharmacist intervention on health care utilization following discharge. METHODS: We used a prospective, alternating month quasi-experimental design to compare outcomes of patients receiving the intervention (n = 358) with controls (n = 366). All patients were discharged to home and were at high risk for medication-related problems following discharge because of the number or types of medications they were prescribed, multiple medication changes during hospitalization, or problems managing medications. The intervention consisted of medication therapy assessment, medication reconciliation, screening for adherence concerns, patient counseling and education, and postdischarge telephone follow-up. The primary outcomes were 14-day and 30-day readmission rates and emergency department visits within 72 hours of discharge. Medication discrepancies occurring at discharge were also characterized. RESULTS: Medication discrepancies at discharge were identified in 33.5% of intervention patients and 59.6% of control patients (P < .001). Although all discrepancies were resolved in the intervention group prior to discharge, readmission rates did not differ significantly between groups at 14 days (12.6% vs 11.5%; P = .65) and 30 days (22.1% vs 18%; P = .17), nor did emergency department visits (2.8% vs 2.2%, respectively; P = .60). CONCLUSION: While our intervention improved the quality of patient discharge by identifying and reconciling medication discrepancies at discharge, there was no effect on postdischarge health care resource utilization.
Paul C. Walker (Mon,) conducted a other in High risk for medication-related problems following discharge (n=724). Pharmacist-facilitated hospital discharge program vs. Control was evaluated on 30-day readmission rate (p=.17). A pharmacist-facilitated hospital discharge program did not significantly reduce 30-day readmission rates compared to control (22.1% vs 18%; P=0.17), despite resolving medication discrepancies.