Impact of a Discharge Medication Therapy Management Program in an Extended Care Hospital

Hutchison, Lydia; Mayzell, George; Bailey, Sandra C.; Broyles, Joyce E.

doi:10.4140/tcp.n.2014.33

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…The intervention enabled to initiate new safer and more effective drugs for patients (15.3%), which made it possible to prevent further disease complications and increase effectiveness of the drug. The achievement made in this study was; however, lower than other studies done in Saudi Arabia (35%), 50 USA (38%) 51 and Mexico (38.3%). 52 This can be due to differences in the healthcare system, study area and healthcare practitioners’ experience.…”

Section: Resultscontrasting

confidence: 82%

Impact of medication therapy management interventions on drug therapy problems, medication adherence and treatment satisfaction among ambulatory heart failure patients at Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia: a one-group pre–post quasi-experimental study

et al. 2022

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ObjectiveTo determine the impact of medication therapy management interventions on drug therapy problems (DTPs), medication adherence and treatment satisfaction among ambulatory heart failure (HF) patients.Study design, setting and participantsA one-group pre–post quasi-experimental study was conducted on 423 ambulatory HF patients at Tikur Anbessa Specialised Hospital (TASH), Addis Ababa, Ethiopia. All ambulatory HF patients ≥18 years old attending the adult cardiac clinic of TASH and having a complete medical record and fully met the inclusion criteria were taken as study participants.InterventionsEducational interventions along with a brochure with information on the nature of HF disease and its treatment were provided to study participants. DTPs encountered were resolved by a team of pharmacists and physicians.ResultsIn the preintervention phase, 288 DTPs were identified with a mean (SD) of 1.3±1.1. A significant reduction of DTPs (0.67±1.1, p<0.001) was observed in the postintervention phase compared with the preintervention phase. At the postintervention phase, 36.4%, 61.9% and 1.7% of HF patients were highly, medium and low adherent to their treatment regimens, respectively. The total composite score for treatment satisfaction of the study participants was 80.35%.ConclusionsThe findings of this study demonstrated that by teaming up clinical pharmacists with cardiologists and cardiology fellows, it was possible to reduce the occurrence of DTPs, improve medication adherence and increase treatment satisfaction of HF patients attending at the outpatient cardiac clinic.

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Section: Resultscontrasting

confidence: 82%

Impact of medication therapy management interventions on drug therapy problems, medication adherence and treatment satisfaction among ambulatory heart failure patients at Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia: a one-group pre–post quasi-experimental study

et al. 2022

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“…Quality improvement programs have been implemented to reduce the number and complexity of discharge medications in order to minimize adverse events and to improve compliance. A pharmacist-directed discharge medication management program has been shown to be successful in decreasing both number and type of discharge medications [ 11 ]. Overall, patient system readmission rates were also significantly decreased in association with implementation of the discharge medication management program [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…A pharmacist-directed discharge medication management program has been shown to be successful in decreasing both number and type of discharge medications [ 11 ]. Overall, patient system readmission rates were also significantly decreased in association with implementation of the discharge medication management program [ 11 ]. However, other programs aimed at minimizing problems with discharge medications to include education and medication reconciliation have not been able to show reductions in the occurrence of hospital readmission [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

The number of discharge medications predicts thirty-day hospital readmission: a cohort study

Picker

Heard

Bailey

et al. 2015

BMC Health Serv Res

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BackgroundHospital readmission occurs often and is difficult to predict. Polypharmacy has been identified as a potential risk factor for hospital readmission. However, the overall impact of the number of discharge medications on hospital readmission is still undefined.MethodsTo determine whether the number of discharge medications is predictive of thirty-day readmission using a retrospective cohort study design performed at Barnes-Jewish Hospital from January 15, 2013 to May 9, 2013. The primary outcome assessed was thirty-day hospital readmission. We also assessed potential predictors of thirty-day readmission to include the number of discharge medications.ResultsThe final cohort had 5507 patients of which 1147 (20.8 %) were readmitted within thirty days of their hospital discharge date. The number of discharge medications was significantly greater for patients having a thirty-day readmission compared to those without a thirty-day readmission (7.2 ± 4.1 medications [7.0 medications (4.0 medications, 10.0 medications)] versus 6.0 ± 3.9 medications [6.0 medications (3.0 medications, 9.0 medications)]; P < 0.001). There was a statistically significant association between increasing numbers of discharge medications and the prevalence of thirty-day hospital readmission (P < 0.001). Multiple logistic regression identified more than six discharge medications to be independently associated with thirty-day readmission (OR, 1.26; 95 % CI, 1.17–1.36; P = 0.003). Other independent predictors of thirty-day readmission were: more than one emergency department visit in the previous six months, a minimum hemoglobin value less than or equal to 9 g/dL, presence of congestive heart failure, peripheral vascular disease, cirrhosis, and metastatic cancer. A risk score for thirty-day readmission derived from the logistic regression model had good predictive accuracy (AUROC = 0.661 [95 % CI, 0.643–0.679]).ConclusionsThe number of discharge medications is associated with the prevalence of thirty-day hospital readmission. A risk score, that includes the number of discharge medications, accurately predicts patients at risk for thirty-day readmission. Our findings suggest that relatively simple and accessible parameters can identify patients at high risk for hospital readmission potentially distinguishing such individuals for interventions to minimize readmissions.

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“…Discontinuation of therapy was the most common intervention, which translated to a decrease in the overall mean maintenance medication per patient potentially affecting risk of readmission (10.57-9.46, P < .001). 14 In a veteran population, Hale and colleagues discovered a trend toward reduction in 90-day death and all-cause readmission for patients who received close follow-up in a pharmacist-managed heart failure bridge clinic (95% confidence interval [CI]: 0.40-1.02; P = .06). 15 Jackevicius and colleagues found inclusion of a clinical pharmacist (CP) within their multidisciplinary heart failure posthospitalization program resulted in a statistically significant reduction in 90-day readmission rate (intervention 7.6% vs control 23.3%; 95% CI: 0.07-0.41; P < .001).…”

Section: Introductionmentioning

confidence: 99%

Aiming Beyond: A Pharmacist Impact on 90-Day Readmissions and Clinical Outcomes Within a Family Medicine Service

Wiegmann

Belisle

Alvarez

et al. 2019

Journal of Pharmacy Practice

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Previous studies have shown pharmacists positively impact 30-day readmission rates. However, there is limited data regarding the effect of clinical pharmacist (CP) follow-up on 90-day readmission or evaluation of disease-specific goals after hospitalization. Investigators analyzed the impact of postdischarge extended CP follow-up within a family medicine service (FMS). The primary end point was all-cause 90-day readmission rates. Secondary end points included all-cause 30- and 60-day readmission rates and the achievement of disease-specific goals postdischarge. Retrospective chart review was performed for patients admitted from August 2016 to November 2017 who were seen by a physician within the FMS 14 days postdischarge. Fourteen percent of patients within the CP intervention group were readmitted within 90 days in comparison to 22% in the standard of care group ( P = .244). Readmission rates at 30 and 60 days were as follows: intervention group 2%, 10%, and standard of care group 16%, 22% ( P = .015, P = .089, respectively). In addition, multiple patients with uncontrolled diabetes who completed CP visits upon hospital discharge met glycemic goals at the end of the study time period. Despite inclusion of the CP in postdischarge care, 90-day readmission rate remained unchanged.

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Impact of a Discharge Medication Therapy Management Program in an Extended Care Hospital

Abstract: The discharge medication management program was successful in decreasing both number and type of discharge medications via pharmacist intervention. Overall, patient system readmission rates were also significantly decreased in the intervention period.

Cited by 7 publications

References 6 publications

Impact of medication therapy management interventions on drug therapy problems, medication adherence and treatment satisfaction among ambulatory heart failure patients at Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia: a one-group pre–post quasi-experimental study

Impact of medication therapy management interventions on drug therapy problems, medication adherence and treatment satisfaction among ambulatory heart failure patients at Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia: a one-group pre–post quasi-experimental study

The number of discharge medications predicts thirty-day hospital readmission: a cohort study

Aiming Beyond: A Pharmacist Impact on 90-Day Readmissions and Clinical Outcomes Within a Family Medicine Service

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