Evaluating provider acceptance of pharmacist interventions in the Discharge Companion Program and its association with readmission reduction
AffiliationUniv Arizona, Coll Pharm, Medicat Management Ctr
Univ Arizona, Coll Pharm, Acad Affairs & Assessment
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CitationJamjoom, O., Marupuru, S., Taylor, A. M., Warholak, T., Scovis, N., & Bingham, J. M. (2020). Evaluating provider acceptance of pharmacist interventions in the Discharge Companion Program and its association with readmission reduction. Journal of the American Pharmacists Association.
RightsCopyright © 2020 American Pharmacists Association. Published by Elsevier Inc. All rights reserved.
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AbstractObjective: To evaluate provider acceptance of pharmacist interventions within the Discharge Companion Program (DCP) and its association with hospital readmissions. Methods: This retrospective record review included patients referred to the DCP between January and October 2018. DCP pharmacists' interventions were assessed for provider acceptance on follow-up consultation or readmission. A chi-square test assessed the association between provider acceptance, communication modality, and technology used. A logistic regression model assessed the association between readmission risk and variables of interest. An a priori alpha level of 0.05 was used. Results: Of the 197 patients referred to the DCP, 102 met inclusion criteria. DCP pharmacists made a total of 271 interventions; 185 (68.7%) required provider action. The most common intervention type was medication addition or discontinuation (n = 74, 40%); the communication mode was between DCP nurses and primary care provider offices or skilled nursing facilities (n = 56, 54.9%); and the preferred technology was the telephone (n = 58, 56.9%). Provider acceptance rate was 30.8% (n = 57) of actionable interventions, although it was not significantly associated with 30-day readmission reductions (P = 0.833) and did not differ significantly when interventions were communicated to other health care professionals (P = 0.53). The specific intervention communication mode (i.e., telephone, facsimile, or both) of pharmacist interventions did not significantly affect provider acceptance (P = 0.133). The overall readmission rate was 22.5% (n = 23), and the only significant predictor of 30-day readmission was the number of comorbidities (odds ratio 1.28 [95% CI 1.03-1.58], P = 0.024). Conclusion: Provider acceptance of pharmacists' interventions did not significantly affect 30-day readmission rates, regardless of communication mode (telephone or facsimile) or technology used. However, the DCP successfully identified numerous medication-related problems. Further study is warranted regarding provider acceptance of pharmacist recommendations on 30-day readmission reduction. (C) 2020 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.
Note12 month embargo; published: 09 January 2020
VersionFinal accepted manuscript