Impact of discharge medication bedside delivery service on hospital reutilization

Patel, Avni; Dodd, Melanie; D’Angio, Richard G.; Hellinga, Robert; Ahmed, Ali; Vanderwoude, Michael; Sarangarm, Preeyaporn

doi:10.1093/ajhp/zxz197

Cited by 12 publications

(7 citation statements)

References 23 publications

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“…The strength of our study is that this analysis includes quantitative data for a large, diverse population in an urban environment and thus could be applicable to a wide array of hospitals and populations. Previous studies have been limited to hundreds of patients instead of thousands 33 . In addition, by stratifying based on CCI and performing cost analyses, we identified objective criteria with which other institutions can target assistance in a world with limited resources.…”

Section: Discussionmentioning

confidence: 99%

Meds to Beds at Hospital Discharge Improves Medication Adherence and Readmission Rates in Select Populations

Stedge¹,

Kubes³

et al. 2023

Southern Medical Journal

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Objectives: Medication nonadherence caused by difficulty obtaining and paying for medicines can increase hospital readmissions. This project implemented Medications to Beds ("Meds to Beds," M2B), a multidisciplinary predischarge medication delivery program, at a large urban academic hospital that provided subsidized medications for uninsured and underinsured patients to reduce readmissions.Methods: This 1-year retrospective analysis of patients discharged from the hospitalist service after implementing M2B contained two groups: one with subsidized medications (M2B-S) and one with unsubsidized medications (M2B-U). Primary analysis was 30-day readmission rates for patients, stratified by Charlson Comorbidity indexes (CCIs) of 0, 1-3, ≥4 to represent low, medium, and high comorbidity burden. Secondary analysis included readmission rates by Medicare Hospital Readmission Reduction Program diagnoses.Results: Compared with controls, the M2B-S and M2B-U programs had significantly reduced readmission rates among patients with CCIs of 0 (10.5% [controls] vs 9.4% [M2B-U] and 5.1% [M2B-S], P < 0.05). A nonsignificant reduction occurred in readmissions for patients with CCIs ≥4 (20.4% [controls] vs 19.4% [M2B-U] vs 14.7% [M2B-S], P < 0.07). Patients with CCIs of 1 to 3 showed a significant increase in readmission rates in the M2B-U, but a decrease in readmission rates among the M2B-S (15.4% [controls] vs 20% [M2B-U] vs 13.1% [M2B-S], P < 0.05). Secondary analyses found no significant differences in readmission rates when patients were stratified by Medicare Hospital Readmission Reduction Program diagnosis. Cost analyses demonstrated that subsidizing medicines cost less per patient for every 1% readmission reduction than delivery alone.Conclusions: Providing medicine to patients predischarge tends to lower readmission rates for populations with no comorbidities or with a high burden of disease. This effect is amplified when prescription costs are subsidized.

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Section: Discussionmentioning

confidence: 99%

Meds to Beds at Hospital Discharge Improves Medication Adherence and Readmission Rates in Select Populations

Stedge¹,

Kubes³

et al. 2023

Southern Medical Journal

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“…Discharge services can be further expanded by incorporating a meds-to-bed program where medications are delivered to the patient's bedside, patients are offered medication counseling, and barriers to medication access are addressed before discharge. 8 Previous literature has suggested that a meds-to-bed program may have an impact on 30-day hospital readmission when it is also combined with additional transitions-of-care interventions, such as medication reconciliation and postdischarge follow-up. 8…”

Section: Discussionmentioning

confidence: 99%

“…8 Previous literature has suggested that a meds-to-bed program may have an impact on 30-day hospital readmission when it is also combined with additional transitions-of-care interventions, such as medication reconciliation and postdischarge follow-up. 8…”

Section: Discussionmentioning

confidence: 99%

Impact of Discharge Medication Reconciliation Across a Five-Hospital Health System

Lee¹,

Kowalski²,

Liu³

et al. 2022

J Healthc Qual

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Purpose:Hospital readmission of a primary diagnosis can have a substantial financial impact via reductions in reimbursement rates up to 3%, and have a negative impact on the lives of patients. Discharge medication reconciliation (DMR) can reduce medication errors that play a role in readmission. The objective of this study is to evaluate the impact of expanding pharmacist-led DMR across a four hospital health system on 30-day readmission rate for high risk of readmission disease groups.Methods:During the 3-month period, DMR was performed for patients with at least one of the disease states associated with a high risk for 30-day readmission, including chronic obstructive pulmonary disease, pneumonia, congestive heart failure, or acute myocardial infarction.Results:The 30-day readmission rate for patients with a high risk for readmission disease state significantly decreased from 17.5% to 15.5% in the pre-expansion to postexpansion phase, respectively (p = .003). Discharge medication reconciliation capture rate increased from 28% pre-expansion to 35% postexpansion. After expansion, the number of DMR interventions reported by pharmacists increased 2.93 times.Conclusion:Expansion of pharmacist-led DMR as a form of transitions of care significantly decreased 30-day readmission rate for high risk of readmission disease groups.

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“…The role of a clinical pharmacist at the time of hospital discharge has been well established in the literature. [74][75][76][77] However, there is no liter- being discharged, rather than picking them up on the way home. 76,77 Further, the clinical pharmacist can address questions related to nutritional deficiencies particularly in recommending and determining appropriate supplements that may be available over-the-counter as treatment options.…”

Section: Hospital Discharge/follow-upmentioning

confidence: 99%

“…[74][75][76][77] However, there is no liter- being discharged, rather than picking them up on the way home. 76,77 Further, the clinical pharmacist can address questions related to nutritional deficiencies particularly in recommending and determining appropriate supplements that may be available over-the-counter as treatment options. A clinical pharmacist ensures that the patient has adequate follow-up scheduled, but also address any questions or possible medication discrepancies in 2 to 3 days after discharge.…”

Section: Hospital Discharge/follow-upmentioning

confidence: 99%

Clinical review and role of clinical pharmacists in obesity management: An opinion of the endocrine and metabolism practice and research network of the American College of Clinical Pharmacy

Clements

Albanese

D’Souza

et al. 2021

J Am Coll Clin Pharm

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The objective of this practice and research network opinion paper was to identify literature for pharmacist-led services with obesity management, summarize clinical evidence for this disease state, and describe the role of a clinical pharmacist among patients who are overweight or have obesity. Clinical pharmacists play a critical role in the safe and effective management of obesity in both the inpatient and outpatient settings. In an outpatient setting, the role of the clinical pharmacist includes a comprehensive patient interview to design an individualized therapeutic plan involving nonpharmacological interventions with or without pharmacological interventions or surgical options. A clinical pharmacist conducts a risk-benefit analysis for pharmacological interventions. Furthermore, the potential of medications to contribute to weight gain or prevent weight loss can be reviewed by a clinical pharmacist when managing comorbid conditions. In an inpatient setting, a clinical pharmacist conducts medication reconciliation, determines appropriate supplements for nutritional deficiencies, and provides medication management for people with obesity who may or may not be undergoing bariatric surgery. In addition, a clinical pharmacist can provide thorough patient education with monitoring for transitions from hospital to the outpatient setting and subsequent follow-up visits.

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Impact of discharge medication bedside delivery service on hospital reutilization

Cited by 12 publications

References 23 publications

Meds to Beds at Hospital Discharge Improves Medication Adherence and Readmission Rates in Select Populations

Meds to Beds at Hospital Discharge Improves Medication Adherence and Readmission Rates in Select Populations

Impact of Discharge Medication Reconciliation Across a Five-Hospital Health System

Clinical review and role of clinical pharmacists in obesity management: An opinion of the endocrine and metabolism practice and research network of the American College of Clinical Pharmacy

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