Tip of the Week: Tailoring Pharmacist-Led Interventions to Reduce Hospital Readmissions

Pharmacists are increasingly involved with interdisciplinary programs for improving patient outcomes, and decreasing costs. Nowadays, pharmacists are increasingly spearheading the creation of such programs.

There is much attention paid to reducing hospital readmissions. This comes especially in light of hospital organizations being financially penalized by payers for discharging patients too sickly and too quickly, only to see those patients readmitted within a short period of time.

A recent study examined a pharmacist-led intervention aimed at reducing hospital readmissions among African-American males (AAMs) with heart failure.¹ Heart failure is responsible for more 30-day readmissions than any other condition. Minorities, particularly AAMs, are at much higher risk for readmission than the general population. In this study, demographic, social, and clinical data were collected from the electronic medical records of 132 AAM patients (control and intervention) admitted with a primary or secondary admission diagnosis of heart failure.

Both studied groups received guideline-directed therapy for heart failure. Additionally, the intervention group received a pharmacist-led intervention that included active education, and demonstration of lifestyle behavioral and disease management techniques. Data collected from these patients were used to validate a predictive model to discern the impact of the pharmacist-led intervention, and to identify predictors of readmission. Results revealed significantly fewer patients in the intervention group readmitted as compared to the control group (11.5% vs. 42.9%). The model also identified other risk variables related to diet, age, social support, and patient self-efficacy.

Pharmacy managers can glean a number of things from this study, the first of which is evidence that pharmacist-led interventions can be effective, and can save organizations considerable monies or provide new job opportunities and revenue streams. It is also important to examine how services can be targeted for specific populations in greatest need, rather than trying to develop services for everyone, including those without unmet needs.

The study also suggests that service outcomes will be optimized by considering a constellation of factors besides the service itself, such as social support and patient self-efficacy, so that the interventions can be further tailored and designed for success.

Additional information about medication therapy management and management functions can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. You or your institution can subscribe to AccessPharmacy to access the textbook.

Shane P. Desselle, RPh, PhD, FAPhA, is Professor of Social/Behavioral Pharmacy at Touro University California. He is author of Chapter 1: The “Management” in Medication Therapy Management and Management Functions in the textbook Pharmacy Management: Essentials for All Practice Settings, 5e.

REFERENCE

McKinley D, Move-Dickinson P, Davis S, Akil A. on 30-day readmission and assessment of factors predictive of readmission in African-American men with heart failure. Am J Mens Health. 2018. doi: 10.1177/1557988318814295