Consultations by CVS pharmacists reduced hospital readmissions

Medication reconciliation programs for patients discharged from hospitals reduced the risk of readmission by 50% and helped avoid unnecessary healthcare costs, according to a new study.

Editor’s Choice: Medicare drug costs should parallel those of Medicaid

Published in the July issue of Health Affairs and led by the CVS Health Research Institute, the study is the first to evaluate the impact of an insurer-supported medication reconciliation program on clinical outcomes and healthcare spending. In this case, the consultations were done by CVS pharmacists.

Troyen A. BrennanAdverse drug events, often attributable to medication non-adherence, are associated with the majority of hospital readmissions, according to Troyen A. Brennan, MD, executive vice president and chief medical officer of CVS Health. Hospital readmissions are associated with more than $41 billion in additional healthcare costs annually and an estimated one in seven patients discharged from hospitals is readmitted within 30 days.

However, in this study, the risk of hospital readmission at 30 days was reduced by 50% because of pharmacists’ medication reconciliation efforts. This effectively reduced the overall risk of hospital readmission from 22% to 11% for those in the medication reconciliation program. Additionally, the national health insurer saved $2 for every $1 spent on the program, resulting in a total savings of more than $1,300 per member.

“This research shows that programs that provide patients with additional support from a pharmacist can help improve health outcomes and save payers and patients money,” Brennan said.

The study analyzed hospital readmissions of more than 260 members of the health plan who were hospitalized over a five-month period. Researchers compared readmission rates for patients enrolled in a med reconciliation program upon hospital discharge to a control group of members who received no additional support following their initial hospital stay.

Those enrolled in the program received an initial in-home or telephonic consultation based on their readmission risk and were also offered ongoing telephonic support for the first 30 days following discharge.

During the initial consultations, pharmacists compared members' pre- and post- hospitalization medication regimens; identified discrepancies, redundancies and safety concerns; and provided education and support regarding medication use and adherence.

The research found that the positive effects of the pharmacist consultation on reducing readmission rates and costs “were similar whether the consultation was conducted via an in-home visit from a pharmacist or over the telephone when the intensity of the intervention was tailored to members' risk," Brennan said.