Key result
Expansion of pharmacist-led discharge medication reconciliation significantly decreased the 30-day readmission rate for high-risk patients from 17.5% to 15.5% (p=0.003).
Why the study?
Hospital readmissions carry substantial financial penalties and patient harm, and discharge medication reconciliation can reduce medication errors that contribute to readmissions.
Does expanding pharmacist-led discharge medication reconciliation reduce 30-day readmission rates in patients with high-risk disease states?
Observational
Yes
Does expanding pharmacist-led discharge medication reconciliation reduce 30-day readmission rates in patients with high-risk disease states?
Absolute Event Rate: 15.5% vs 17.5%
p-value: p=.003
Expanding pharmacist-led discharge medication reconciliation significantly reduces 30-day readmissions in high-risk patients, including those with heart failure and myocardial infarction.
Pharmacist-led DMR expansion was associated with reduced 30-day readmissions in high-risk groups; leaves open whether prospective trials will confirm system-wide benefit.
PURPOSE: Hospital readmission of a primary diagnosis can have a substantial financial impact via reductions in reimbursement rates up to 3%, and have a negative impact on the lives of patients. Discharge medication reconciliation (DMR) can reduce medication errors that play a role in readmission. The objective of this study is to evaluate the impact of expanding pharmacist-led DMR across a four hospital health system on 30-day readmission rate for high risk of readmission disease groups. METHODS: During the 3-month period, DMR was performed for patients with at least one of the disease states associated with a high risk for 30-day readmission, including chronic obstructive pulmonary disease, pneumonia, congestive heart failure, or acute myocardial infarction. RESULTS: The 30-day readmission rate for patients with a high risk for readmission disease state significantly decreased from 17.5% to 15.5% in the pre-expansion to postexpansion phase, respectively ( p = .003). Discharge medication reconciliation capture rate increased from 28% pre-expansion to 35% postexpansion. After expansion, the number of DMR interventions reported by pharmacists increased 2.93 times. CONCLUSION: Expansion of pharmacist-led DMR as a form of transitions of care significantly decreased 30-day readmission rate for high risk of readmission disease groups.
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A 2022 study conducted an observational in High risk of readmission disease groups (COPD, pneumonia, CHF, AMI). Pharmacist-led discharge medication reconciliation (DMR) expansion vs. Pre-expansion phase was evaluated on 30-day readmission rate (p=.003). Expansion of pharmacist-led discharge medication reconciliation significantly decreased the 30-day readmission rate for high-risk patients from 17.5% to 15.5% (p=0.003).
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