Up to 26% of Hospital Readmissions are Preventable and Medication-Based

In another victory for those looking to expand the pharmacist’s role, a new study has found that having pharmacists lead an intervention in hospitals can reduce medication-related hospitalization readmissions in high-risk patients.

The study, to be published in the upcoming issue of JAPhA, the APhA’s journal, looked at a pharmacist-led care transition model. The model, called Pharm2Pharm, was implemented in both rural and urban areas in Hawaii. The researchers examined 401 readmissions during a 14-month period to better describe how a quality improvement practice can help reduce medication-related readmissions.

The study found that 26% of readmissions were potentially preventable and medication-related. The most common reasons given were nonadherence due to patient choice (23.8%), an untreated condition for which medication is indicated (13.3%), dose too high (10.5%), and dose too low (10.5%).

In more rural areas, the number of preventable readmissions was higher (30%) than in urban areas (17%).

Pharm2Pharm allows hospital consulting pharmacists to identify patients at risk of readmission related to medication and then refer those patients to a community consulting pharmacist when they are discharged. Both the hospital and community pharmacists help the patients identify and resolve drug therapy problems.

Because the most common medication-related problem was non-adherence due to patient choice, the consultant pharmacists were trained in Motivational Interviewing (MI), which is one of the few approaches that has been shown to address a broad range of health-related behavior problems. Many pharmacists reported that the training was helpful in working with non-adherent patients.

Beyond MI, the researchers found that “the bigger opportunity for pharmacists to add value in patient care roles is through ensuring patients are prescribed optimal medication regimes according to evidence-based guidelines … pharmacists can play a key role in getting patients on the right medications and on the right doses.”

The study was conducted by researchers from the Daniel K. Inouye College of Pharmacy at the University of Hawaii at Hilo.