Jessica E Fennelly1, Antoinette B Coe2, Kellie A Kippes1,2, Tami L Remington1,2, Hae Mi Choe1,2,3. 1. Pharmacy Innovations and Partnerships, Michigan Medicine, Ann Arbor, MI, USA. 2. University of Michigan College of Pharmacy, Ann Arbor, MI, USA. 3. University of Michigan Medical Group, Ann Arbor, MI, USA.
Abstract
BACKGROUND: An ambulatory transition of care program, including a pharmacist-provided comprehensive medication review (CMR), was implemented. OBJECTIVES: The objectives were to: (1) compare 30-day hospital readmission rates between those who received the pharmacist CMR versus eligible patients not scheduled, (2) describe identified problems and recommendations, and (3) quantify recommendation acceptance rates. METHODS: A retrospective cohort study was conducted between March and October 2016. Inclusion criteria were: LACE score of ≥13, established Michigan Medicine primary care, and discharged from specific inpatient services to home. The primary outcome was 30-day hospital readmission rates. Pharmacist-identified problems, recommendations, and recommendation acceptance rates were examined. χ2 analysis and descriptive statistics were used. RESULTS: 355 discharges met inclusion criteria and pharmacists provided CMRs for 159 patients. The average age was 60 years (standard deviation [SD]: 14.3), the majority were female (54%), and white/Caucasian (69%). There was no significant difference in 30-day readmission rates in patients who received a CMR (p = .96). A mean of 3.1 problems were identified per visit (SD: 1.8, range: 1-10). 509 recommendations were provided and approximately 50% were provider accepted. CONCLUSIONS: Reduced readmission rates were not observed; however, pharmacists identified many areas for intervention in highest risk patients during the transition from hospital to home.
BACKGROUND: An ambulatory transition of care program, including a pharmacist-provided comprehensive medication review (CMR), was implemented. OBJECTIVES: The objectives were to: (1) compare 30-day hospital readmission rates between those who received the pharmacist CMR versus eligible patients not scheduled, (2) describe identified problems and recommendations, and (3) quantify recommendation acceptance rates. METHODS: A retrospective cohort study was conducted between March and October 2016. Inclusion criteria were: LACE score of ≥13, established Michigan Medicine primary care, and discharged from specific inpatient services to home. The primary outcome was 30-day hospital readmission rates. Pharmacist-identified problems, recommendations, and recommendation acceptance rates were examined. χ2 analysis and descriptive statistics were used. RESULTS: 355 discharges met inclusion criteria and pharmacists provided CMRs for 159 patients. The average age was 60 years (standard deviation [SD]: 14.3), the majority were female (54%), and white/Caucasian (69%). There was no significant difference in 30-day readmission rates in patients who received a CMR (p = .96). A mean of 3.1 problems were identified per visit (SD: 1.8, range: 1-10). 509 recommendations were provided and approximately 50% were provider accepted. CONCLUSIONS: Reduced readmission rates were not observed; however, pharmacists identified many areas for intervention in highest risk patients during the transition from hospital to home.
Entities:
Keywords:
LACE risk tool; ambulatory care pharmacy; care transitions; comprehensive medication review; readmissions
Authors: Erin Slazak; Amy Shaver; Collin M Clark; Courtney Cardinal; Merin Panthapattu; William A Prescott; Samantha Will; David M Jacobs Journal: Pharmacy (Basel) Date: 2020-01-04