Journal of Evaluation in Clinical Practice

Clinical pharmacist home visits and 30‐day readmissions in Medicare Advantage beneficiaries

Journal Article

Abstract

Rationale, aims & objectives

A variety of transition of care interventions has been evaluated to date to reduce readmissions. No studies evaluated effectiveness of clinical pharmacist's home‐visits to recently discharged Medicare Advantage patients with the goal of preventing subsequent readmissions and urgent care use. The objective of this study was to evaluate the effectiveness of in‐home clinical pharmacist's transition of care program on 30‐day all‐cause readmissions, emergency department (ED) visits, outpatient visits, as well as to assess patient satisfaction with the program.

Methods

The study used retrospective cohort design.

Results

A total of 245 patients were included in the study (mean (SD) age 77.8 (8.7); mean Charlson's Comorbidity Index 5.0 (2.5); 53.5% male). Forty‐seven patients (19.0%) experienced at least one ED visit and twenty‐two patients (9.0%) were readmitted within 30 days. The two groups did not differ on available demographic and clinical characteristics (p > 0.05). There was no difference in 30‐day readmission rates, percent of patients with ≥1 ED visit, ≥1 outpatient physician office visit between the groups (p > 0.05). A total of 78 program participants responded to a satisfaction survey with 95% agreeing the program helped to stay healthy at home.

Conclusion

Multiple medication‐related problems were identified by in‐home pharmacists and the program appeared to be well‐accepted by participants. In this study we did not find that the program had an impact on reduction of inpatient or urgent healthcare use. Further research using a different study design and a larger sample to estimate the program effectiveness is warranted.

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