Impact of an Integrated Pharmacy Transitions of Care Pilot Program in an Urban Hospital

J Pharm Pract. 2016 Oct;29(5):490-4. doi: 10.1177/0897190014568674. Epub 2015 Mar 5.

Abstract

Purpose: To evaluate the effectiveness of an integrated Pharmacy Transitions of Care (PTC) pilot program on reducing hospital readmissions and improving patient satisfaction.

Methods: This prospective observational cohort study compares patients who participated in the PTC program to a control of usual hospital discharged patients during January through April 2014. The PTC program provided discharge medication review, medication counseling, delivery of medications to bedside, clinic scheduling, and follow-up phone calls. The primary outcome measure was 30-day readmissions. Secondary outcomes included emergency department (ED) visits, pharmacist interventions, and patient satisfaction.

Results: Seventy patients participated in the PTC program. Compared to the control (n = 725), the study group had decreased 30-day all-cause readmissions (5.7% vs 13.8%, P = .08), 30-day readmissions for the same diagnosis (2.9% vs 8.1%, P = .18), and ED visits (18.6% vs 25%, P = .82). Twenty-five interventions during discharge medication review included discontinuation of unnecessary medications and correction of medication dose or frequency. The majority of patients were satisfied with the medication education provided (94%) and the timely delivery of prescriptions to bedside (96%).

Conclusion: There was no significant difference in 30-day readmission rates. However, pharmacists were able to make a positive impact on patient satisfaction and improve understanding of medications during discharge.

Keywords: discharge; education; pharmacy; readmissions; transitions of care.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Medication Reconciliation
  • Middle Aged
  • Patient Medication Knowledge
  • Patient Readmission / statistics & numerical data
  • Patient Satisfaction
  • Patient Transfer / organization & administration*
  • Pharmacy Service, Hospital / organization & administration*
  • Pilot Projects
  • Young Adult