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. 2019 Mar-Apr;59(2):202-209.
doi: 10.1016/j.japh.2018.10.011. Epub 2018 Dec 11.

Impact of a community pharmacy transitions-of-care program on 30-day readmission

Amy Shaver, Melissa Morano, Jill Pogodzinski, Stacy Fredrick, David Essi, Erin Slazak

Impact of a community pharmacy transitions-of-care program on 30-day readmission

Amy Shaver et al. J Am Pharm Assoc (2003). 2019 Mar-Apr.

Abstract

Objectives: The primary objective of this study was to evaluate the impact of a transitions-of-care (TOC) program on both all-cause and related 30-day hospital readmission. The secondary objective was to evaluate which patient-specific factors, if any, are predictive of 30-day hospital readmissions.

Design, setting, and participants: A TOC program in an outpatient pharmacy, driven primarily by student pharmacists, provided telephone-based counseling to recently discharged patients. The calls were conducted within 2 to 7 days after discharge and focused on medication counseling and reconciliation, as well as promotion of a physician follow-up visit. The goal of this program was to decrease hospital readmissions among patients discharged with a cardiovascular-related diagnosis. Patient-specific information was recorded in a spreadsheet, including discharge diagnosis, and readmission diagnosis for those who returned to an inpatient facility within 30 days. This study was a retrospective chart review. Data were manually extracted from the program's data spreadsheet and the institution's electronic medical record for patients referred to the TOC program from June through November 2017. Patients discharged to hospice, prison, or a long-term care facility were excluded from analysis. Researchers collected information on patient demographics, diagnoses, and readmissions. Data analyses were performed with the use of SAS 9.4.

Outcome measures: The primary outcome measure was 30-day all-cause readmission, and the secondary measure was 30-day related readmission.

Results: A total of 1219 encounters were examined. Compared with those patients without TOC participation, those who used the TOC program had a 67% decreased odds of all-cause 30-day readmission (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.22-0.48; P < 0.0001) and a 62% decreased odds of a related readmission (OR 0.38, 95% CI 0.18-0.82; P = 0.008).

Conclusion: Community pharmacists and Advanced Pharmacy Practice Experience-level student pharmacists have the potential to make a significant impact on reducing hospital readmission rates.

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Conflict of interest statement

Conflicts of interest: Currently Melissa Morano is the Supervising Pharmacist for High Street Prescription Center, a Kaleida Health employee (at the time of the study she was a staff pharmacist for High Street Prescription Center); currently Jill Pogodzinski is the Director of Community Based Services for the VNA, a Kaleida Health employee (at the time of the study she was the Family Pharmaceutical Services Manager and Supervising Pharmacist for High Street Prescription Center). All other authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Study sample attrition Key: TOC = transitions of care; SNF = skilled nursing facility; LTCF = long-term care facility
See this image and copyright information in PMC

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