Pharmacist outreach cuts readmission rates for patients on high-risk meds

Pharmacist outreach to patients admitted to the hospital on high-risk medications or on at least three medications at discharge can help reduce the readmission and emergency department (ED) visit rates during the 30 days following discharge, according to a study in the Journal of Hospital Medicine.

In a prospective, randomized study from November 2012 through June 2013 at an urban medical center, patients in the study group (n=137) received face-to-face medication reconciliation, a pharmaceutical care plan, discharge counseling, and three phone calls after discharge-at day 3, 14, and 30, which provided education and counseling. There were 141 patients in the control group that received the usual standard of care.

Fewer patients in the study group (n=34), 24.8%, had to be readmitted or visited the ED in the 30-day postdischarge window, compared with 39% in the control group (n=55), reported Michael Postelnick, RPh, BCPS, of the Northwestern Memorial Hospital in Chicago, and his co-authors.

Postelnick told The Hospitalist, a publication of the Society of Hospital Medicine, that three postdischarge phone calls was a unique protocol as most studies included one or two at the most. “But we thought of the midpoint of the 30-day period postdischarge as a very hazardous time, a time that would benefit from pharmacist contact to make sure that patients were continuing on their plan and not having any problems,” he said in The Hospitalistreport.

Additional results

The study also tracked the number of medication errors and adverse drug events (ADEs) and patient’s knowledge of their medications as determined by improved scores of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).

In the study group, 11 patients, or 8%, had an ADE or medication error, compared with 18 patients, or 12.8%, in the control group, which was not statistically significant, the authors wrote.

In addition, there was a 9% improvement in the HCAHPS scores during the study period, which was not statistically significant, they noted.

“The study demonstrated that pharmacist involvement in hospital discharge transitions of care had a positive impact on decreasing composite inpatient readmissions and ED visits,” the authors concluded. “Patients with moderately complex medication regimens benefited from a continuity of care involving a pharmacy team during transitions of care.”