COPD, discharge counseling, hospital readmission
Objective: To determine the impact of pharmacist-provided discharge medication counseling on 30 and 90 day hospital readmissions and ED visits in patients admitted with COPD exacerbation.
Methods: A hospital-wide improvement was initiated, where COPD patients received discharge medication counseling and follow up phone call by a pharmacist. A pilot study was implemented, and data on readmission rates at 30- and 90-days were collected and compared to a hand-matched, retrospective control group that had not received discharge counseling by a pharmacist. Differences in readmission rates were analyzed using Chi-squared tests.
Results: A total of 28 patients received discharge counseling by the pharmacist and were compared to 28 retrospective patients. Differences in 30-day and 90-day readmission rates were not significant (p=1.000 and p=0.589, respectively). After thirty days, 7 (25%) intervention and 7 (25%) retrospective group patients had been readmitted. After ninety days, 11 (39.3%) intervention and 13 (46.4%) non-intervention patients had been readmitted. Since a small cohort of patients received discharge counseling, the study did not meet power.
Conclusions: Although not statistically significant, patients who received discharge medication counseling provided by a pharmacist had lower 90-day readmission rates post discharge. As regulations are implemented that penalize hospitals for readmissions that occur within 30 days of discharge, it is imperative that health care systems develop new strategies aimed at reducing readmission rates. Further studies that are adequately powered are needed to assess the impact pharmacists can have on readmission rates.
Laswell EM, Svelund EA, Harzler ML, Chambers KD, Chen AM. Discharge Medication Counseling and its Correlation with Reducing Readmissions for Patients with Chronic Obstructive Pulmonary Disease Exacerbations. Inov Pharm. 2015;6(3): Article 214. http://pubs.lib.umn.edu/innovations/vol6/iss3/10.