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12/05/2014

Medication Adherence and Hospital Readmissions

Whether patients are getting medications, seeing a primary care provider, discharged from a hospital, or getting emergency care, they are being shifted between different health care providers. Transitions of care is an important aspect of healthcare because it allows smooth movement of patients from one setting to another.

Transitioning from the hospital to home can be difficult for patients, potentially leading to readmission if the transition is not well coordinated. Kirkham conducted a retrospective cohort study in two acute care hospitals in the United States to see the effect of a collaborative pharmacist-hospital care transition care program on the likelihood of 30-day readmission rates. The two-year study showed patients who did not receive bedside delivery of post discharge medications and follow-up telephone calls were twice as likely to be readmitted within 30 days of discharged than those who did receive these services. For patients greater than 65 years of age, the pharmacist transition of care resulted in a six-fold decrease in 30-day readmission rates. As this study shows, a transition of care program can be associated with a lower likelihood of readmission and pharmacist participation can be of significant benefit.  

A study conducted by Bellone reviewed 131 patients aged 18 to 65 on at least three prescription medications. The intervention group consisted of patients that pharmacists visited within 60 days of discharge to provide medication counseling or dosage adjustments, while the control group did not receive any intervention. The intervention group had an 18.2% hospital readmission rate compared to 43.1% in the control group (P = 0.002).  Pharmacists can optimize medication adherence during transitions of care to reduce readmission rates. The American Pharmacist Association and American Society of Health-System Pharmacists released a Medication Management in Care Transitions Project to display popular models from across the country that improve patient outcomes by involving pharmacists in medication-related transitions of care. Some of the roles and responsibilities of pharmacists in these practices include: medication reconciliation, counseling on medication therapy, contacting the patient’s home for follow-up, preparing medications etc. Through these interventions pharmacists are involved in patient care from inpatient to home settings.

Transition of care pharmacists can be a beneficial aspect in the health care system. By providing appropriate interventions, pharmacists can decrease the likelihood of hospital readmission.

Urvi Patel, PharmD ‘16

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